Although a decision by the U.S. Supreme Court regarding the constitutionality of the Affordable Care Act is imminent, many provisions likely would remain in effect unless the court invalidates the entire ACA.
Contrary to the portrayal of the ACA by opponents as federally directed, state leaders and state agencies play the central role in configuring access to ACA benefits and protections.
Nevertheless, the law has been met with fierce and persistent opposition from Florida's elected and appointed leadership, and state-level efforts to implement the ACA have remained at a virtual standstill for more than a year and a half. This inaction and outright resistance raises a question of whether Floridians might face delayed or denied access to the intended benefits of the ACA's key reforms as they take effect during the next few years. On the more immediate front, it gives rise to questions about the extent to which Floridians have access to the limited but important ACA benefits that should already be available to them.
Despite the fact that Florida remains mired at "square one" in implementing the ACA, Florida insurers nevertheless appear to be generally compliant with the effective provisions of the ACA, and millions of Floridians are benefiting as a result.
These findings are cause for both confidence and concern among Florida consumers. While indications are that insurers have taken and will make some effort to comply with the law, the extent and level of compliance will be considerably lower and less continuous without strong transparency requirements and enforcement mechanisms by the state.
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