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Why Florida Was Most At-Risk In Obamacare Supreme Court Ruling


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President Obama’s signature health law survived yet another Supreme Court examination. Florida would have been hit the hardest if the ruling went the other way.

WMFE Health Reporter Abe Aboraya spoke with Morning Edition host Nicole Creston.

NICOLE: Polling shows 72 percent of Americans knew nothing at all or only a little about King V. Burwell. So what was this case about?

ABE: Most people think of the law as health reform, but much of the law really deals with health insurance. And it tackles reform in three big ways. One, insurance companies can’t deny you coverage because you’re sick. Two, it requires most Americans to carry insurance, so it’s not only sick people getting it. And three, it provides billions in tax breaks to make that insurance affordable. This case was a technical look at how those tax breaks can be delivered in 34 states where the federal government runs health care marketplaces, or www.healthcare.gov

NICOLE: Is Florida one of those 34 states?

ABE: Indeed. And Florida has more people signed up than any other state in the country.

NICOLE: The justices ruled that subsidies can continue to flow to states like Florida. How many people does that impact?

ABE: To some degree, everyone. In Florida, 1.3 million people were in danger of losing these tax breaks for health insurance. That’s more than $389 million dollars coming into Florida every month.

NICOLE: But Abe, you said this affects everyone to some degree. What did you mean by that?

ABE: So let’s think about Jane Consumer. Jane Consumer in Florida gets $294 per month shaved off her average health insurance bill. Had the Supreme Court ruled the other way, it would have triggered what insurance people like to call the “death spiral.” This is where anyone who’s young and healthy stops buying insurance because, well, it’s $300 more a month, so then there are fewer healthy people in the mix, and then everyone’s insurance rate goes up. And that’s how it affects nearly everyone to some degree.

NICOLE: What are Floridians saying about this decision?

ABE: There’s a sense of relief. Miami resident Celia Maluf is a yoga instructor who gets those subsidies. She says having health insurance reduces her stress, that you secrete adrenaline every day when you don’t have insurance.

“The fear that was lifted today, oh my, it is delicious,” Maluf said. “I want to savor the moment for quite a bit longer.”

Other people we spoke with said they got tears in their eyes when the decision came down, and that insurance has saved their family from bankruptcy. One woman in Pine Hills, her insurance premium with tax breaks was $27, and without it, it was $500.

NICOLE: How are Florida lawmakers responding to this decision?

ABE: We spoke with Republican Scott Plakon of Longwood. He says Obamacare top to bottom is fiscally irresponsible, that it steals from our children’s piggy banks to finance the health care needs of today.

“Nothing in Obamacare addresses the cost of health care,” Plakon said. “There are numerous ideas that have been out there for years. I’m hoping this will spur Congress to exploring those more seriously.”

NICOLE: What if the court had gone the other way? What would have happened to the 1.3 million Floridians on the federal exchange?

ABE: There was a batter on deck to take www.HealthCare.Gov’s place. Before Marco Rubio was running for president, he was speaker of Florida’s House, and he created Florida Health Choices. It’s very similar in style to www.HealthCare.Giv, except there are no tax breaks, and Senate President Andy Gardiner wanted to turn that into the state’s health exchange.

Here’s Rose Naff, CEO of Florida Health Choices.

“Certainly, the state of emergency is avoided now,” Naff said. “States can continue to consider that option in a thoughtful way and no special session or grand discussion needs to take place.”

NICOLE: What are you hearing from hospitals and health care providers?

ABE: Florida Hospital told us that a million-plus Floridians continuing to have access to preventive health care keeps those minor health issues from becoming emergencies. That, they say, is good for everyone’s insurance rates. And nonprofit clinics were also fretting about a jump in the uninsured.


WMFE is a partner with Health News Florida, a statewide collaborative reporting on health care.

Health reporting on WMFE is supported in part by AdventHealth.

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Abe Aboraya

About Abe Aboraya

Health Reporter

Abe Aboraya started writing for newspapers in High School. After graduating from the University of Central Florida in 2007, he spent a year traveling and working as a freelance reporter for the Seattle Times and the Seattle Weekly, and working for local news websites in the San Francisco Bay area. Most recently Abe ... Read Full Bio »

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