Democratic U.S. Sen. Bill Nelson urged Florida Gov. Rick Scott to veto legislation his fellow Republicans advanced that suspends for two years the state’s authority to set health insurance rates.

Nelson, a former state insurance commissioner, said in a Wednesday letter to Scott that allowing the bill (SB 1842) to become law would put consumers at risk of sky-high rate hikes.

“To eliminate the Florida insurance commissioner’s authority to turn down rate increases is unbelievable and unconscionable.”  Nelson wrote.

Nelson’s criticism echoes that raised during the session by legislative Democrats who said the legislation appeared designed to shield state regulators from any fallout stemming from the Affordable Care Act. Among them would be Chief Financial Officer Jeff Atwater, a Republican and former Senate president from North Palm Beach, whose office oversees the Office of Insurance Regulation.

Proponents of the legislation, however, said it is merely aimed at helping the state comply with evolving regulatory requirements under the federal health care overhaul.

Group or individual health plans in place in 2010 will still be subject to rate review by state regulators, under SB 1842. But the host of new coverage options expected to be created when the Affordable Care Act takes effect in January will have rates controlled by federal agencies, although Atwater’s office will still review the proposals.

When the proposal was advanced in the Legislature, Republicans insisted they were not trying to shift blame for any problems that could rise from the influx of coverage plans and new companies.

They said that since the federal government has been imposing so many new regulations on the state, it made sense that federal officials do the rate-setting.

“This is not changing the consumer tradition of this state,” Rep. John Wood, R-Winter Haven, said at a House hearing last month. “But it is giving us
flexibility to understand a changing landscape.”

Democrats have been angered by the Republican-ruled Legislature’s long reluctance to enact provisions of the Affordable Care Act. They also said the new measure will give consumers the runaround in dealing with any issue with health insurance rates.

“We can do better for consumers,” said Rep. Jose Rodriquez, D-Miami, said during the April hearing.

Supporters of the Affordable Care Act continue to criticize the Legislature’s move.

“Senate Bill 1842 brings bad news for Florida consumers in at least two distinct ways: it deregulates health insurance at the state level, putting consumers at risk; and, it sets up ACA to be blamed for Florida’s irresponsibility,” said the Jupiter-based health advocacy group, FloridaCHAIN.

Scott has until June 5 to act on the legislation.

Gov. Rick Scott grumbled some and hinted Thursday at vetoing some hometown spending sought by top lawmakers if the Legislature fails to act on his legislative proposals.

Scott’s biggest pitch — drawing Medicaid dollars to expand health care for low-income Floridians — looks doomed in the House. The House also has allowed to languish Scott’s push to eliminate the sales tax for manufacturers buying new equipment.

Meanwhile, House and Senate budget negotiators also have dismissed Scott’s $2,500 across-the-board teacher pay raises. They want to hand out the dollars solely based on merit.

“In the budget, for the first time since 2006, we have a surplus. I want to make sure we spend the money well,” Scott told reporters. “So, I would expect, like I did the last two years….I want to make sure we get a good return on our investment.”

Asked if he has targeted some spending already, Scott said, “There’s a lot of projects in there. I’m going to look at them closely. Legislators, I’m sure will want to come explain some spending. I have my priorities. I want to do the right thing for this state.”

With the House and Senate divided over whether to accept federal dollars to expand health insurance for poor Floridians, Senate budget chief Joe Negron said Tuesday that he is open to finding a middle ground.

Negron, R-Stuart, is scheduled to shepherd a proposal through a Senate budget subcommittee Wednesday that relies on federal money to reposition the Florida Healthy Kids program to accept $51 billion in federal aid over the next decade.

Negron wants to create a Healthy Florida program to cover the potential 1 million uninsured adults and children who could be eligible for coverage under the Medicaid expansion allowed states by the federal Affordable Care Act.

The House and Senate have both rejected the Medicaid expansion earlier sought by Gov. Rick Scott, but the governor, Senate leaders, and most health care advocates have since signed onto the Negron proposal.

The House, however, is rejecting the federal money. House Speaker Will Weatherford, R-Wesley Chapel, and his likely successor, Rep. Richard Corcoran, R-Land O’ Lakes, say the promise of a steady stream of federal dollars is unreliable.

Instead, House leaders are advancing a proposal that would cover only 115,000 low-income parents, children and disabled at a cost to state taxpayers of $237 million-a-year.

A similar Senate proposal by Sen. Aaron Bean, R-Fernandina Beach, also is expected to be reviewed by the Senate budget panel Wednesday.

“My goal is for people to have health insurance, with them paying part of these premiums,” Negron said. “I would prefer a premium assistance program along the lines of the Senate plan. But this process requires people of good will to enter into principled agreements with the other side.”

Negron said that some sort of “hybrid” proposal — incorporating portions of his plan and the House proposal — is the only approach that will fly this session.

“I think for any plan to succeed this session, it would have to have elements of the House and Senate plans in it,” Negron said.

Although federal Health and Human Services Secretary Kathleen Sebelius told states last December not to expect full federal funding with a partial expansion of Medicaid coverage, Negron said he felt federal officials will be ready to deal.

“I would think that the federal government would want the citizens of Florida to have private health insurance rather than show up at emergency rooms when it’s too late, frequently,” Negron said.

While the House plan would cover 115,000 and Negron’s approach would bring 1 million Floridians insurance coverage, the senator said it was still unknown how many the “hybrid” will insure.

Almost 4 million Floridians currently have no health insurance. Where will the hybrid land?

“Somewhere in between. It depends on where you draw the line,” Negron said.

Weeks after Republican legislative leaders defied Gov. Rick Scott and refused to expand Medicaid, the House rolled out a health insurance plan Thursday that parallels a longshot proposal already introduced in the Senate.

The House would build on Florida Health Choices, a five-year-old insurance marketplace designed for individuals and small businesses.

Sen. Aaron Bean, R-Fernandina Beach, has advanced a similar approach in the Senate, where it has drawn little support compared with a more ambitious proposal from Senate budget chairman Joe Negron, R-Stuart.

With just over three weeks remaining before the Legislature’s May 3 adjournment, the battle lines are clear. While Scott and Negron have expressed support for drawing billions of federal dollars to finance health coverage for an additional 1 million Floridians, the House proposal shuns federal money.

“The Florida House has developed a plan that will fit the needs of Florida, not the requirements of Washington,” said House Speaker Will Weatherford, R-Wesley Chapel.  “Our plan increases our commitment to a strong safety net and ensures Floridians are not on the hook for billions that we currently do not have.”

The House’s Florida Health Choices Plus would cover an additional 115,000 uninsured Floridians at a cost of $237 million annually to state taxpayers. Florida has close to 4 million residents without health coverage, contributing to hospitals losing $2.8 billion in charity care last year.

Democrats, hospitals and health-care organizations have joined advocates for low-income Floridians in pressing Republican leaders to embrace the Medicaid expansion allowed states under the Affordable Care Act.

Florida stands to draw $51 billion in federal aid at a cost to taxpayers of $3.5 billion over the next decade — with the first three years of the expansion fully paid for by the federal government.

Negron’s proposal in the Senate, if approved by the full Legislature and signed into law by Scott, is seen as likely winning approval from the Obama administration. That would clear the way for it to be financed as an alternative to the Medicaid expansion.

Following the plan’s release, House Democrats and Scott found rare symmetry.

Both sides gave a nod to the effort by House Republicans — but said it fell short.

House Democratic Leader Perry Thurston of Fort Lauderdale called it “bare-bones health coverage.”

“Though personally, at a glance, I am not enthralled by the proposal, I recognize that it is at least a minimal attempt toward achieving a legislative compromise on the important topic of health coverage for Floridians,” Thurston said.

Scott weighed-in supporting the Senate plan.

“The House’s plan will cost Florida taxpayers on top of what they are already taxed under the president’s new health care law,” Scott said. “This would be a double-hit to state taxpayers.”

He added, “The Senate’s plan will provide health care services to thousands of uninsured Floridians while the program is 100 percent federally funded. As it stands today, the Senate’s plan is in line with what I said I would support because it protects both state taxpayers and the uninsured in our state.”

Much of the proposal released Thursday by the House was devoted to making a case against expanding Medicaid. The Health Choices Plus plan would cost low-income Floridians $25-a-month, letting them choose from a variety of insurance options supplemented by $2,000 annually in taxpayer contributions.

Those taking part in the program would be expected to be employed, unless they could not work because of a disability.

Health care advocates earlier questioned the similar Bean proposal in the Senate — saying it’s lack of significant financing would blunt the kind of coverage Floridians could obtain.

Florida hospitals and health care advocates rallied Tuesday at the state Capitol to urge lawmakers to endorse expanding Medicaid — only hours after a state Senate committee said the state should come up with its own program for insuring 1 million low-income residents.

But the harshest critics of the move by the Republican-led panel was a House Republican, Rep. Mike Fasano of New Port Richey. He dismissed it as just another delaying tactic by Florida Republican leaders who have long opposed the federal Affordable Care Act.

“That’s a cop out. Nothing more than a cop out,” Fasano told supporters rallying on the Old Capitol steps.

He accused fellow Republicans of “making excuses not to accept federal dollars for those who are needy.”

A Senate committee examining the federal health care overhaul Monday defied Gov. Rick Scott’s call for expanding Medicaid.

Instead, the chairman of the panel, Sen. Joe Negron, R-Stuart, said lawmakers should begin work this session on an alternate approach that would need to gain federal approval. He said the Florida Healthy Kids program could be expanded to offer health coverage to 1 million individuals, families and children.

The Senate proposal is a tall order. But it comes only a week after a House committee also dug in and said it would not support expanding Medicaid to 138 percent of the poverty level — an option facing lawmakers who could draw $51 billion in federal money into the program over the next decade at a cost of about $3.5 million to the state.

Bruce Reuben, president of the Florida Hospital Association, said his association continues to push for expanding Medicaid. But Reuben said he was pleased that lawmakers at least say they will try to find a way to pull the federal money into a Florida-centric progam.

“I’m encouraged that they’re looking at something very seriously and very thoughtfully,” Reuben said. “I don’t know enough about the details yet to know whether it’s something that’s truly viable.”

Hospitals have looked to Medicaid expansion for help in reducing the almost 4 million Floridians who have no health insurance. Hospitals lost $2.8 billion last year in charity care — treating patients who had no coverage.

“For us, getting people covered is the issue. What you call it, is really not that important,” Reuben said.

On the eve of the start of the 2013 Legislature, Gov. Rick Scott was dealt a blow Monday when a House committee killed his push for Medicaid expansion.

In a party-line vote, 10 Republicans on the House’s committee on the Affordable Care Act, voted against expansion; five Democrats sided with the Republican governor, who recently dropped his longtime opposition to the measure, which is expected to make 1 million lower-income Floridians eligibile for Medicaid.

“What you saw today was theater of the absurd,” said Rep. Mark Pafford, D-West Palm Beach, following the vote.

House Republicans took turns at the microphone to question expansion, saying it put the state at risk for future costs and relied on funding from a federal government which is weathering a host of fiscal challenges. Rep. Richard Corcoran, R-Land O’ Lakes, at one point likened the state relying on federal assurances of fully paying costs for the first three years of expansion as similar to tthose offered investors in Bernie Madoff’s Wall Street schemes.

“You cannot rely on someone giving us money when they are borrowing 50-cents on the dollars,” Corcoran said.

The House action came only hours after a Senate committee postponed its scheduled hearing where there was the possibility of a vote on expansion. But committee chairman Joe Negron, R-Stuart,  raised hopes among many health care advocates by speaking generally about how Florida should make every effort to assure that Florida’s 4 million uninsured become eligible for some kind of health coverage.

The House vote likely sets the stage for a session-long fight over expansion. The politics have been complicated, with Scott getting clear support from Democrats long accustomed to opposing his policies, while Republicans are divided, at best.

Defying conservatives in his own party, Scott said he wants the Legislature to approve expanding Medicaid to 138 percent of the poverty level, a move which would make eligible almost 1 million Floridians.

Medicaid already serves 3.2 million people and absorbs almost one-third of the state’s $70 billion budget. But saying no to expansion just means Florida tax dollars will be spent in other states, supporters have said.

Under the expansion, the federal government would pay for 100 percent of the expansion until 2016, when states would start paying a 5 percent share that would gradually increase to a maximum of 10 percent of new costs by 2020.

Estimates vary, but analysts have said Medicaid expansion could bring Florida $26 billion in federal dollars over the next decade. Florida taxpayers are expected to pay $3 billion during that period, according to the state’s Agency for Health Care Administration.

Supporters pushing Gov. Rick Scott and the Republican-controlled Legislature to approve Medicaid expansion under the federal health care overhaul said the move would provide a needed jolt to Florida’s still-fragile economy.

Families USA released a report that said making more lower-income Floridians eligible for health coverage under Medicaid will yield 71,300 new jobs and pump $8.9 billion more in economic activity into the state.

Ron Pollack, executive director of Families USA, said given the broad social and economic reach of a Medicaid expansion, “A refusal would be an act of fiscal malpractice.”

House and Senate committtees examining the Affordable Care Act and its effect on Florida are looking likely to recommend a direction on Medicaid expansion by early March.  Among the considerations, is whether the federal government will approve the state’s 2011 request to move most of the state’s current 3.2 million Medicaid enrollees into managed care.

Sen. Joe Negron, R-Stuart, chairman of the Senate panel reviewing the law, told the Palm Beach Post there is “clearly a nexus between the two.”

“Without the waiver, we are not likely to move ahead with expansion,” Negron said.

Federal officials have been negotiating with the state for two years on the managed care shift, but the two sides are expected to be close to reaching agreement.

Families USA, a health care advocacy organization, said that many of the new jobs it forecasts will be created in the health care industry, already a huge employer in Florida. But the amount of revenue pumped into the state with the expansion — which could amount to $26 billion over the next decade — will also course through many areas of the workforce, the report concludes.

The Obama administration has approved Florida’s first step toward moving Medicaid patients into managed care programs — endorsing an approach advanced two years ago by the Legislature that stalled awaiting federal action, Gov. Rick Scott said Monday.

The waiver approved by the Centers for Medicare and Medicaid Services under the Department of Health and Human Services allows state officials to begin moving long-term care patients into managed care programs. The state has already chosen five health plans that patients and their families can choose from. Scott was expecting a decision by Thursday, but federal officials informed Florida of the approval late Friday.

“I am appreciative that HHS approved one of our two important Medicaid waivers, and that they have done so before the February 7^th deadline,” Scott said. “The additional flexibility provided through this waiver helps improve our current system, and HHS approval allows us to begin implementing changes to our current Medicaid program.”

A larger waiver, allowing for a full, statewide managed care program is still awaiting approval. Scott urged federal officials to OK that plan, which is emerging as an element in the state’s consideration of embracing the Medicaid expansion authorized under the Affordable Care Act.

Florida’s Medicaid toll has spiked with the recession and its aftermath.  Medicaid costs now absorb close to one-third of the state’s $70 billion budget.

Scott and leading Republican lawmakers, however, say the managed care approach can save Florida money. Medicaid’s costs also rise with fraud and waste, which lawmakers said managed  care companies would have more incentive to erase.

The federal application builds on the HMO-styled health coverage plans   introduced for Medicaid patients in Broward, Baker, Clay, Nassau and Duval   counties, beginning in 2006. But that program has drawn mixed reviews from   policy analysts, who question purported cost-savings and quality of patient   care.

Many patients have complained about dealing with a revolving door of managed   care plans, or having to travel long distances to receive specialty care.

Voters age 50 and older overwhelmingly back legislative efforts to ban texting-while-driving, a new survey by AARP shows.

Some 93 percent of older voters polled support the prohibition, compared with only 5 percent who say they oppose such a law. The Legislature has considered some kind of text-ban for more than a decade, but advocates say the measure faces its best chance of becoming law this year.

A measure banning texting (SB 52) is slated to go before the Senate Transportation Committee on Wednesday.

AARP has 2.8 million members in Florida.

In other matters covered in the December survey of 880 Floridians, AARP found a majority (52 percent) support requiring online retailers to collect the state’s 6 percent sales tax from consumers, the same as brick-and-mortar retailers. Another 60 percent oppose the 2006 law that allowed Florida Power & Light and Progress Energy of Florida to collect money for nuclear power plants before building them.

House Speaker Will Weatherford, R-Wesley Chapel, has said he’s open to taking another look at the law.

AARP, which is supporting the Medicaid expansion Gov. Rick Scott and Florida lawmakers are still considering,  also found most surveyed want more state attention and money going to long-term care.

The survey has a margin-of-error of plus-or-minus 3.3 percent.

After resisting the federal health care overhaul for months, Florida’s ruling Republicans are reluctantly warming to the idea that it is not going to be repealed.

Senate President Don Gaetz said Monday that his chamber has established a website for Floridians to track legislative action on the Affordable Care Act and to offer input. The site is:  http://www.flsenate.gov/topics/ppaca.

“The new portion of the Senate website was created to serve as a centralized location for interested parties to watch meetings, read bills and share their viewpoints with the committee,” said Gaetz, R-Niceville, who announced the website’s debut along with Sen. Joe Negron, R-Stuart, chairman of a Senate select committee working on the state’s implementation of the ACA.

The first meeting of the select committee drew a host of tea party protesters, who urged that the Legislature continue to resist the federal law — insisting that it’s unconstitutional. Gaetz and Negron dismissed the criticism.

Among the initial tasks facing lawmakers is how to create required health exchanges, the online marketplaces where Floridians would obtain health insurance once the program is in place in 2014, and whether to expand state Medicaid coverage.

Senate President Don Gaetz, R-Niceville, has raised the hackles of Florida tea party activists on the warpath about Gaetz and other GOP leaders’ apparent willingness to go along with the once-reviled “Obamacare.”

With more than a dozen supporters backing her up, tea party lawyer KrisAnne Hall heatedly told a Senate committee exploring implementation of the federal health care act they should nullify the law because it is unconstitutional. The raucous crowd repeatedly burst into applaud and even booed one senator who refuted their position.

Hall had a short confrontation with Gaetz after the meeting and apparently sent him an e-mail explaining “the Founders’ position on State Sovereignty and nullification,” according to her blog.

Gaetz, a sharp-tongued history buff who often punctuates his arguments with sarcasm, replied to Hall and others with a history lesson about Andrew Jackson. First, Gaetz reminds Hall that he opposes the law and also believes it’s unconstitutional.

“As to nullification, I tend to favor the approach used by Florida’s first Governor, Andrew Jackson:

It is said that one evening, while he was president, General Jackson was interrupted in his reading in his bedroom by an alarmed military aide who breathlessly reported, “Mr. President, the “nullifiers” are in front of the Executive Mansion with torches and guns. They are screaming that each state has the right to decide for itself which federal laws to follow. They threaten to burn us down if you will not agree with them.”

Without lifting his head from his reading, Andrew Jackson said, “Shoot the first nullifier who touches the Flag. And hang the rest.”

I have sworn an oath on my father’s Bible before Almighty God to preserve, protect and defend the constitution and government of the United States. And that’s exactly what I intend to do. Count me with Andrew Jackson.

Senator Don Gaetz

The e-mail sparked a firestorm in the tea party community, including on Hall’s Facebook page.

“After sending Senator Don Gaetz my letter explaining the positions of James Madison, Thomas Jefferson and Alexander Hamilton on State Sovereignty, Mr. Gaetz says that citizens who agree with the writer of the Declaration of Independence should be summarily shot and hanged. Does that means Don Gaetz is in favor of shooting the many Catholic Bishops and other religious leaders who have said that they will not comply with this mandate? Notice the double-speak in his email below. He affirms his support for the Constitution and then demonstrates his utter ignorance of its meaning and purpose,” Hall wrote on her blog.

Caught outside the Senate Democratic suite where Gaetz lunched with Democratic Leader Chris Smith and others, Gaetz downplayed the brewing battle between the “nullifiers” and the president and clarified that he was not advocating shooting tea partiers.

“No. I’d have to shoot my son,” Gaetz said. Rep. Matt Gaetz is an even more conservative Panhandle lawmaker than his father.

Gaetz explained the use of the Jackson anecdote.

“That’s just an old tale of what was said about what Andrew Jackson said. I simply sent it to her as a way to try to let her know that you can still be civil about these issues and you don’t have to be outraged about every single thing. You can disagree without being uncivil,” he said.

Gov. Rick Scott continued Wednesday to shift away from his once staunch opposition to the federal health care overhaul, with his office underscoring his willingness to negotiate how Florida can take part in the effort.

Scott last week told the Palm Beach Post that ”just saying no is not an answer,” to the Affordable Care Act, a position that has become clear following President Obama’s re-election.  Scott had expected the election of Republican Mitt Romney and a Republican-controlled Congress to lead to repeal of the 2010 law.

But Thursday, Scott’s office issued a press release containing an Associated Press story in which the governor is quoted saying he is looking to work with federal officials on implementing the law in Florida.

“The election is over and President Obama won. I’m responsible for the families of Florida…If I can get to yes, I want to get to yes,” Scott is quoted.

The health care law requires consumers to carry insurance beginning in 2014 face a penalty.  Coverage would be purchased through online health marketplaces — called exchanges — employer-provided insurance, Medicaid or Medicare. Some who can’t afford insurance will be eligible for subsidies.

If Florida doesn’t establish its own exchanges, the federal government will do it for the state. Scott and other governors have until Friday to tell federal officials if they plan to implement their own exchanges. States planning to do so must supply a blueprint by Dec. 14.

Scott and incoming House Speaker Will Weatherford, R-Wesley Chapel, both acknowledge that Florida would be hard-pressed to meet these deadlines. Scott and Republican leaders in the Legislature effectively have ignored provisions of the Affordable Care Act, rejecting millions of dollars in benefits already offered states.

The National Federation of Independent Business, which early on joined Florida and 25 other states in challenging the Affordable Care Act, condemned the Supreme Court’s decision Thursday that maintains central parts of the sweeping law.

“Florida’s small-business owners have been fighting this battle alongside the Florida Attorney General’s office from day one, and after months of uncertainty and frustration, the Court’s decision is grave disappointment to them,” said Bill Herrle, NFIB-Florida’s executive director.

 “The increasing costs of health-care are the number one concern for the small-business community, and this flawed law does nothing to address cost,” he added.

States are likely to find some silver lining in the ruling, which stops short of imposing strict penalties on those that don’t comply with a major expansion of Medicaid coverage. But for businesses opposed to the measure, there is little to cheer.

 “This day will go down in history as the day when Americans lost a part of their freedom – the freedom to choose what to buy with their money,” said Karen Harned, executive director of NFIB’s Small Business Legal Center.

Although states’ rights is a key part of the challenge raised by Florida and 25 other states to the federal health care overhaul, a similar argument failed to sway a majority of U.S. Supreme Court justices ruling Monday in a Montana campaign finance case.

The argument already failed to move Florida Attorney General Pam Bondi, who declined a request  to have Florida join 22 states and the District of Columbia siding with Montana in urging  justices to allow it to structure its own unique finance law.

Florida, however, is a lead plaintiff in the effort to overturn the federal health care law, on similar states’ rights grounds.

Rep. Jeff Clemens, D-Lake Worth, was among those urging Bondi to intercede in the Montana case, especially given Florida’s aggressive defense of states’ rights in health care.

“I was surprised Florida isn’t on that list,” Clemens wrote Bondi in a letter last month. “If corporate interests are allowed to use the Citizens United decision to encourage corporate corruption and patronage at the state level, the likely outcome is that average, everyday citizens will lose their voice.”

 Bondi’s own website says the state’s motive for challenging the federal health care law as unconstitutional is because the measure exceeds federal authority and infringes on individual liberty and states’ rights. Her office has said it did not see a need for Florida to intervene in the Montana case. 

Justices ruled 5-4 Monday that Montana could not ignore the 2010 Citizens United decision, which ruled that the First Amendment bars limiting independent political spending by corporations and unions. The court ruled such expenditures “do not give rise to corruption or the appearance of corruption.”

With Florida leading a multi-state challenge to the federal health care overhaul, Gov. Rick Scott said Wednesday that he will “comply with the law,” if it is upheld by the U.S. Supreme Court.

In a conference call organized by opponents of the Affordable Care Act, Scott essentially echoed statements he’s made for months — even as a ruling by justices is expected within the next 10 days.

“If it’s the law of the land, then we’re going to comply,” Scott said. “But I’m very optimistic that the Supreme Court will either declare it unconstitutional or it will be repealed.”

Scott acknowledged that a congressional repeal could happen only if presumptive Republican presidential nominee Mitt Romney defeats the health care overhaul’s main champion, President Obama, this fall. Similarly, Scott said states should be given authority by the federal government to design their own Medicaid programs — which he said would reduce costs.

Scott sees a Romney presidency has central to that wish coming true.

“Whether we get a bloc grant or not is going to be dependent on the national election,” Scott said.

Before he became governor, Scott, a multimillionaire health care entrepreneur, made his first foray into politics by founding Conservatives for Patients’ Rights. The political committee ran ads in 2009 opposing President Obama’s health care plans.

As governor, Scott told the Palm Beach Post last year that the measure approved by Congress and signed into law by the president in 2010 is “not the law of the land.” While he said the state would meet its obligations if the Supreme Court upholds the law, he added: “I don’t believe it will ever be the law of the land.”

Just weeks after he was sworn in, Scott halted plans put in place by his predecessor, Gov. Charlie Crist, for health insurance exchanges, a central part of the federal plan.

The state also has turned back grants to allow long-term care patients to return home, to reduce child abuse through in-home counseling and to educate teenagers on preventing pregnancy.

In this spring’s legislative session, Scott and Republican legislative leaders refused $438.5 million in federal money aimed at increasing Medicaid payments to doctors.

A legislative panel gave Gov. Rick Scott’s administration approval Wednesday for a $3.4 million grant drawn from the federal Affordable Care Act, the measure backed by President Obama which Florida’s Republican chief executive ridicules regularly.

The Legislative Budget Commission agreed to take the cash to provide home visiting services to at-risk families. But Sens. Joe Negron, R-Stuart, and Don Gaetz, R-Niceville, urged lawmakers to reject the funding, warning that the program’s services were murky and that if federal dollars dry up, the state could be left covering the cost.

“It’s overly intrusive,” Negron said, adding he was wary of what he called the government’s “amorphous assistance.”

Scott and the state’s Republican-led Legislature has drawn national attention for rejecting federal grants aimed at moving nursing home patients back into their homes and providing in-home counseling to families where child abuse was a looming threat. Funding for these services and others were turned down because they stem from the Affordable Care Act — which many in the GOP deride as ObamaCare.

The Legislative Budget Commission, though, went along with the Scott administration’s request to accept this latest round of grant money Wednesday. A Republican majority on the panel endorsed the move, chiefly because rejecting it would have made Florida ineligible for as much as $100 million in future learning and development grants under the federal Race to the top legislation.

House budget chair Denise Grimsley, R-Sebring, said she was offended by the linkage. But she made it clear she didn’t like the program and felt such steps created a dependency for at-risk families.

“We have generations of individuals depending on government,” Grimsley said, adding, “it’s a no-win situation.”

Gov. Rick Scott, who’s fought against federal health care reform since its inception, said today Florida won’t begin implementation of the federal health care law ruled unconstitutional by a judge yesterday.

“We are not going to spend a lot of time and money with regard to trying to get ready to implement that until we know exactly what is going to happen,” Scott told reporters this morning. “I hope and I believe that either it will be declared unconstitutional or it will be repealed.”

U.S. District Court Judge Roger Vinson ruled yesterday that critical components of the Patient Protection and Affordable Care Act are unconstitutional. The Department of Justice indicated it would file an appeal and ask the judge to issue a stay on his order.

Attorney General Pam Bondi, who picked up the challenge after her predecessor Bill McCollum initiated the lawsuit, said she and the 25 other states who’ve joined Florida’s lawsuit are trying to decide whether to by-pass the appellate court and seek resolution directly from the Supreme Court, which both sides agree will ultimately rule on the law.

Scott said he is not concerned about whether a delay in implementing the law in Florida could create problems if the Supreme Court upholds it.

Scott said state officials “will have enough time” to implement the measure before the 2014 deadline.

“The state won’t be caught flat footed,” Scott said. “We’ll be ready.”