pinion Despite Resistance in Tallahassee, Florida is Top Obamacare State

The Florida Legislature has worked as hard as any other state to obstruct the Affordable Care Act (aka Obamacare), refusing to set up insurance exchanges and turning away more than $50 billion to expand Medicaid to more of the state's poor and uninsured. Yet despite those roadblocks, our state has become perhaps the biggest success story of the President's signature program.

As of mid-January, 1.27 million Floridians had enrolled in exchange plans, according to government data. That is 115 percent of the federal government's enrollment target for that time point. 673,000 Floridians selected a health plan on the exchange during the first month of 2015's open enrollment – more than any other state – and because the first-month data doesn't include those whose policies were automatically renewed, the next enrollment report should look even more promising.

Florida has fared far better in terms of getting residents enrolled than California or Texas has, other similar states that have comparable problems with uninsured citizens. While Florida's progress has been impressive, our state remains tied with Texas, both states sporting an embarrassing 22 percent uninsured rate, while California's is currently at 17 percent according to the most recent data.

Overall, 7.1 million Americans are enrolled in a plan through the federal exchange (HealthCare.Gov), while 2.4 million enrolled through state marketplaces, a total number that is also above President Obama's goals for this stage of the game. That says a lot. That says that despite a concerted effort to spread disinformation about costs and coverage and the fact that Congress has been just as obstructive as Republican legislators at the state level, the program is advancing and more Americans are gaining access to health insurance.

Is the Affordable Care Act perfect? Far from it. For starters, it contains a lot of overpayment to appease special interests in the health insurance and hospital industries. Rather than enact cost-saving reforms and use the savings to fund expansion (as its creators intended), the President ultimately went for expansion first and promised savings later.

Was there a better way to do it that actually had a chance to get through? Probably not. Universal health care, or in this case, universal health insurance coverage, has been politically DOA for decades. Why? At the risk of oversimplifying, it's because, more than any other nation in the world, people get obscenely rich providing health care in the United States. Whenever there are more than a handful of people raking in an obscene amount of income in an industry, it is bound to create a very powerful lobby intent on protecting that dynamic.

Yet as impossible as reforming it may seem, there was no choice as to whether we could have attempted to tackle this great challenge. Health care simply cannot continue to outpace table top inflation by 300 percent, sucking up far more than its fair share of American consumers' collective budget and effectively keeping it out of non-health care related markets that have to continue to fight for a smaller slice of the pie, because let's face it, few things in health care spending fall into the "optional spending" category.

I don't think that Obamacare, at least in its current form, will be the end-all solution to our country's health care woes. However, I think it will lead us closer to a solution that will. If nothing else, the process has helped to shine a light on the vast inefficiencies in the American market, making a stronger argument for a true national health care model like the rest of the developed world already has.

I used to work in the health insurance industry and always said that if Americans were forced to understand the way our health care is delivered, how poor our results are per dollar spent, and exactly how rich some interests get in the process (especially non-doctors), they'd be picketing in the streets to get something closer to the British model.

Well, they're not being forced to understand, but the attention has brought more of the realities to light, and many more are wondering why we pay so much more than other developed nations to get results that are often worse and never measurably better.

With so much more data on the table, one can easily see that the industry's stock answers – frivolous malpractice litigation, our obesity or smoking rates, or inferior care in other countries with nationalized health care – are either fallacies or don't even amount to a blip on the radar.

They're instead realizing that we have a broken system, one that allows, and in some case incentivizes profiteering. They are also starting to understand that because it is a market in which, by nature, things like consumer choice, market competition and cost transparency don't exist, being pro-free market and pro national health care aren't mutually exclusive by any means. 

As the ACA has gotten off the ground, Republicans in Congress have softened their stance into repeal and replace, but when pressed on most items that actually are part of Obamacare (insuring minors on their parent's plans for longer, removing previous condition obstacles, etc.) and not special interest propaganda that isn't (it pays for abortions, is more expensive, etc.), they have been hard pressed to give details on what exactly they would change.

In Tallahassee, our lawmakers have sat on their hands, promising to find a state-level solution, while simply kicking the can down the road, session after session. Again, if the status quo is breaking the back of our economy, Americans left only to choose between an improvement of any kind and more of the same are going to embrace what they're offered. Maybe that's what the President has been counting on all along.

Dennis Maley's column appears every Thursday and Sunday in The Bradenton Times. He can be reached at dennis.maley@thebradentontimes.com. Click here to visit his column archive. Click here to go to his bio page. You can also follow Dennis on Facebook.