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Obamacare had little effect on timing of workers’ comp claims, study says

An insurance industry analysis undermines any assumption that employees delay reporting weekend injuries into the work week to take advantage of workers’ compensation benefits.

Were that true, one might expect the number of workers’ comp claims filed during the work week to have declined since the Affordable Care Act brought 8 million people into the ranked of the insured.

That didn’t happen, according to an analysis by the National Council on Compensation Insurance, or NCCI — an industry data clearinghouse that recommends premium levels in states including Florida.

The study did find a slightly higher number of claims reported on Monday than any other day of the week. But there was no noticeable change after the ACA took effect — not any day of the work week.

The findings held up even accounting for whether a state saw large or small changes in its uninsured population under the ACA.

“Even though WC claim frequency continues to improve—following a trend that began long before the ACA — this study has not found any effect on claim frequency that can be reasonably attributed to the implementation of the ACA,” the study’s authors
reported.

The study compared workers’ comp claims filed between January 2012 and December 2013 — before the ACA — and those between January 2014 and December 2015.

Lost-time claim frequency declined by about 7 percent post-ACA. “This is in line with the long-term decline in WC claim frequency that extends back several decades, prior to the ACA,” the report says.

Monday claims ran slightly ahead of other days of the week. But the difference was minimal — 18.1 percent compared to 17.8 percent on Tuesday and Wednesday, with declining shares through the rest of the week.

The ACA had no effect at all on claims filed on Monday through Wednesday, and minimal changes to other days of the week.

Even when comparing states with high levels of ACA coverage with those with less, there was little if any difference.

“At the state level, there is no apparent relationship between the changes in Monday claim shares and changes in the shares of the population uninsured for health care,” the study found.

Even though it didn’t take advantage of the ACA’s Medicaid expansion, Florida ranked among the high-coverage rates, with its uninsured rate declining by 6.8 percent post-ACA. The state’s decline in Monday claims was just 0.13 percent.

Florida uninsured rate increases, tops national average

More than 2.6 million people in Florida lacked health insurance at some point in 2017, according to data released Wednesday by the U.S. Census Bureau.

That means about 12.9 percent of the state’s population last year was uninsured — up from 12.5 percent in 2016 — as Florida continued to be higher than the national average of 8.8 percent.

“Florida is going in the wrong direction, and Florida already had a high uninsured rate to begin with,” said Joan Alker, executive director and research professor at the Center for Children and Families at the Georgetown University McCourt School of Public Policy.

Nationally, the data showed that about 1 in 4 uninsured people were 26 to 34 years old, and about 1 in 5 uninsured people were ages 34 to 44. Data also indicated that the uninsured tended to have lower incomes and were more likely to have high-school educations or less.

Florida had the fifth-highest rate of uninsured residents in the nation, with the higher states Texas (17.3 percent), Oklahoma (14.2 percent), Alaska (13.7 percent) and Georgia (13.4 percent).

The release of the new numbers comes at a time when health care remains one of the top issues dividing Florida political leaders and as it has become a key issue during this year’s elections.

Democrats have long called for expanding Medicaid eligibility under the federal Affordable Care Act to include uninsured childless adults with incomes at or below 138 percent of the federal poverty level. But the Republican-controlled Legislature has rejected the idea.

Before his 2014 re-election campaign, Republican Gov. Rick Scott came out in favor of Medicaid expansion but later resumed his opposition to the idea. Scott is running for the U.S. Senate this year, trying to unseat longtime Democratic incumbent Bill Nelson.

Scott spokesman McKinley Lewis said the narrative that Medicaid expansion is a cure-all “just isn’t’ true” and that “19 states that expanded Medicaid have seen an increase in the number of uninsured.”

“Florida’s Medicaid program is operating at an all-time high in efficiency and service to Florida families,” Lewis said. “The fact is, Gov. Scott has offered significant proposals on how Washington can increase quality and access to health care.”

After President Donald Trump was elected, Scott called for Congress to repeal the federal health-care overhaul, which was pushed into law by former President Barack Obama and is commonly known as Obamacare. The effort ultimately failed, although Florida is now part of an ongoing lawsuit that could dismantle key portions of the law.

A closer look of the new data shows that in Florida, about 45 percent of people with insurance in 2017 obtained it through their employers. Medicare, the government-run program for people 65 and older, and Medicaid, which covers the poor, elderly and disabled, account for 21.7 percent and 18.6 percent of the insured population respectively. Another 3 percent of Floridians with health insurance obtained it through the Veterans Administration, according to the data.

The remaining people obtained their insurance, according to the Census data, by directly purchasing policies. For many people, that meant buying policies on the federal health-care exchange, which was created through the Affordable Care Act.

Jodi Ray, director of the organization Florida Covering Kids & Families, said she wasn’t surprised by the Census data.

Florida Covering Kids & Families works to provide education, training and enrollment assistance to help people obtain health coverage. As she travels the state, it’s not unusual for her, she said, to speak with residents who aren’t aware that they can enroll in the federal health insurance exchange.

“It never fails to shock me when I hear them say, ‘I thought that went away,’ “she said.

Florida Democrats hit ‘right-wing extremist’ Ron DeSantis on health care

The Florida Democratic Party (FDP) is out with a new campaign hitting Republican gubernatorial candidate and former U.S. Rep. Ron DeSantis on his long-running opposition to the Affordable Care Act.

The FDP released a new video titled “DeSantisCare,” as well as a new website looking to highlight DeSantis’ health care record. We reached out to the DeSantis campaign for comment on the FDP’s efforts and are awaiting a reply.

The video and website pose as mock ads for the new “DeSantisCare.” While purporting to sell viewers on the idea of DeSantisCare, the new video and site are littered with jabs at the Republican’s health care proposals.

“Are you a senior who is tired of Medicare and just want to be uninsured?” the video’s narrator asks.

“Are you against protections for pre-existing conditions? If yes, then this is big.”

The video then cuts to a clip of DeSantis on Fox Business saying, “I want to repeal all of Obamacare.”

“From Ron DeSantis, there’s now a health care plan that will make sure you pay more for less: DeSantisCare,” the narrator continues.

The parody video then turns to claims of what DeSantis’ health care policies may mean for Florida, interspersed with other past clips of DeSantis criticizing Obamacare’s efforts to reform the nation’s health care system.

“Enjoy the golden years with higher prices, below-average care and increased risk of death,” the narrator says.

“While using DeSantisCare, go to the emergency room immediately if you experience foot in mouth, diarrhea, MAGA, increased anxiety, Fox News addiction, paranoid conspiracy theories, headaches or a fever. These are not all the possible side effects, as DeSantisCare may make existing problems worse.”

DeSantis has long opposed Obamacare and voted to repeal and replace the law with the American Health Care Act. Those efforts died in the Senate last year.

“Ron DeSantis has consistently voted against Florida’s seniors and working families in Washington,” said FDP Chairwoman Terrie Rizzo.

“Instead of putting Florida families first, DeSantis is a right-wing extremist who has voted to take away Floridians’ health care, raise health care costs, take away protections for pre-existing conditions, and destroy Medicare. DeSantis failed to stand up for Floridians in Washington — so why would we want to give him a promotion?”

DeSantis is competing with Tallahassee Mayor Andrew Gillum to be Florida’s next Governor. DeSantis announced Monday morning he was resigning from Congress immediately in order to focus on his campaign against Gillum.

‘Goodbye, Congressman’: Democrats’ ads hammer Carlos Curbelo on health care

A new series of ads from the Democratic Congressional Campaign Committee knock U.S. Rep. Carlos Curbelo on his vote last year to repeal the Affordable Care Act.

The 30-second ads depict two fictional letters addressed to Curbelo.

The first spot, titled “Open Letter,” imagines a health care executive thanking Curbelo for increasing his company’s profits at the expense of voters’ health care needs.

“Dear Congressman Curbelo, I’m following up on behalf of the insurance industry and our almost $75,000 in contributions,” says the fictional health care executive portrayed in the ad.

“Thanks for voting with us to increase the cost of health care in your district. Thanks for voting to allow an ‘age tax,’ and thanks for voting to end protections for pre-existing conditions. Our profits are up! Here’s another check to help you stop Debbie Mucarsel-Powell – who fought to increase access to affordable health care.

“Thanks, Carlos. Keep up the good work.”

The GOP’s efforts to repeal the bill were unsuccessful after the attempts to repeal failed in the Senate. Nevertheless, premiums shot up in 2018 throughout Florida as compared to the previous year.

It’s possible they will increase further after Republicans successfully repealed the ACA mandate in the GOP tax bill which passed late last year.

The second ad, titled “Kathy,” shows a mock Curbelo supporter who is now switching her vote in light of his decision to get rid of the ACA, otherwise known as “Obamacare.”

“Dear Congressman Curbelo, I voted for you last time,” the fictional voter begins.

“Then, back in Washington, you voted against me. You voted with [Donald] Trump and the Republicans to take away our health care. You voted to allow insurance companies to charge an ‘age tax’ on older Americans. And you voted to gut protections for those of us with pre-existing conditions.

“This time I’m supporting Debbie Mucarsel-Powell. She fought to save taxpayers money by lowering health care costs. Goodbye, Congressman Curbelo.”

The DCCC is also releasing a Spanish version of that ad.

The Curbelo campaign responded to the ads, arguing insurers were actually in favor of the ACA.

“It’s ironic how quickly Washington Democrats forget that big insurance endorsed the ACA because it guaranteed their profits and put special interests before patients,” said Joanna Rodriguez, spokesperson for the Curbelo campaign.

“Mucarsel-Powell is clearly out of touch with the needs of our community if she’s going to support a status quo of ever-increasing premiums and deductibles and fewer choices that make the insurance coverage Americans do have ineffective.”

Curbelo’s vote on the failed health care bill is likely to be a recurring issue in the general election contest between he and Mucarsel-Powell, his Democratic opponent in Florida’s 26th Congressional District.

“Congressman Curbelo answers to his party, special interests and President Trump over his constituents in South Florida, and voters know that he has betrayed them in Washington,” said Cole Leiter, DCCC spokesperson.

“Curbelo’s vote to make healthcare more expensive for Floridians, particularly harming those who are older or living with pre-existing conditions, is a glaring example of how his loyalty to party and special interests hurts the community he is meant to represent. Debbie Mucarsel-Powell is the only candidate voters can trust to protect their affordable health care.”

Election forecasters see this as a competitive race, though with Curbelo a slight to moderate favorite.

Modest insurance hikes come amid health care debate

Florida Democrats vowing to make health care a priority in the November elections got a jolt of surprising news this week that could reshape the ongoing back-and-forth over former President Barack Obama’s health-care overhaul.

The state Office of Insurance Regulation late Tuesday released data that showed health-insurance premiums won’t balloon as much as some had feared amid moves by the Trump administration to dismantle the Affordable Care Act.

The office reported on average that rates will increase 5.2 percent for individuals who receive coverage through the federal health-insurance exchange, beginning in January. That means the premium for a 28-year-old adult living in Monroe County earning $27,000 annually should be an average of $115 month for a “silver” plan. That’s the lowest average rate in the state, according to an OIR chart.

Conversely, the highest costs for the plan will be in Okeechobee County, where that 28-year-old person would pay, on average, $333 a month for the same policy.

The rate increases are some of the lowest ever requested by Florida insurance companies since the federal health law passed in 2010.

The law, often referred to as Obamacare, requires insurance companies to issue policies to people regardless of any pre-existing conditions. It also provides cost-sharing reductions for people who qualify.

But the federal law also required insurance companies to cover certain health benefits and prevented companies from limiting coverage. Those changes apply to all insurance policies, including those sold to employers in the private market through group plans.

For individual policies, carriers submitted rate requests to the Office of Insurance Regulation ranging from a high of a 10.5 percent increase submitted by Blue Cross and Blue Shield of Florida to a low of 5.6 percent, submitted by Florida Health Care Plans. On average, regulators instead approved a 5.2 percent increase for individual policies.

The costs of group health insurance increased by an average of 6 percent for the 2019 year, according to the OIR data. Those policies are not bought on the federal exchange and are not subsidized.

The program Florida Covering Kids and Families at the University of South Florida works with state agencies and others to advocate and conduct outreach to help people have access to affordable health coverage.

Jody Ray, the director of the organization, didn’t know “what to expect” when it came to insurance rates for the 2019 year.

“This is really good news for Florida,” she said.

An insurance premium is the amount of money that an individual or business must pay for a policy. Premiums reflect the expected health care costs of the risk pool as well as the costs of the care.

Florida Association of Health Plans President and CEO Audrey Brown said in a statement that the recent rate approval is in line with medical inflation and “indicates an overall market stabilization.”

Congress this year eliminated a mandate included in the federal health law that people must buy insurance policies or face tax penalties. The move raised concerns that, without the mandate, only those who are unhealthy would continue to purchase health insurance through the federal exchange.

Moreover, the Trump administration has made clear that it will not defend the Affordable Care Act against the latest legal challenge brought by 20 Republican-led states, including Florida.

Gov. Rick Scott and other Republican leaders have consistently opposed the sweeping law, which has helped lower the percentage of uninsured citizens in the state and nation. Florida’s uninsured rate in 2013, the year before Obamacare plans became available, was 20 percent and one of the highest in the nation. In 2016, the rate was 12.5 percent.

Florida also has consistently led the nation in the number of people who enroll in the federal exchange under the law.  Last year, more than 1.7 million Floridians entered the marketplace to buy a plan. The vast majority, more than 90 percent, received federal financial help to reduce their monthly premiums.

State regulators, who work for an agency controlled by Scott and three other Republicans, released the health-insurance data the same day as Florida’s primary elections.

Tallahassee mayor Andrew Gillum captured the Democratic nomination for governor edging out four opponents, and Republican Congressman Ron DeSantis won the GOP nomination.

Gillum supports Obamacare, while DeSantis has voted to repeal the law. In a conference call on Wednesday, some of the state’s top Democrats made clear that they would ensure health-care access is a priority issue.

“Make no mistake, health care is on the ballot this November,” said Congressman Ted Deutch, whose district includes parts of Broward and Palm Beach counties.

Rick Scott ad accuses Bill Nelson of cutting Medicare when he voted for Obamacare

Republican U.S. Senate candidate Gov. Rick Scott is launching a new television commercial accusing his opponent, Democratic U.S. Sen. Bill Nelson, of voting to cut Medicare when he voted for the Affordable Care Act.

The 30-second spot, “Unfair,” will be playing on television and in digital internet advertising. It charges Nelson with supporting Medicare cuts and helping put Medicare in financial straits because he voted yes on the Affordable Care Act, also known as Obamacare, in 2009.

The commercial doesn’t actually mention the Affordable Care Act or Obamacare, only citing the bill number and vote number. The commercial contends the vote led to a cut of $716 billion from Medicare. It is an allegation that Republicans have been charging, and Democrats refuting, since the Affordable Care Act was first approved in December 2009, though the exact number of the alleged cuts has varied. By 2012 Republicans were consistently citing $716 billion.

That year PolitiFact sought to check the claim and rated it “Mostly False.” PolitiFact, a project operated by the Tampa Bay Times (then the St. Petersburg Times) wrote, “While the health care law reduces the amount of future spending growth in Medicare, the law doesn’t actually cut Medicare. Savings come from reducing money that goes to private insurers who provide Medicare Advantage programs, among other things.”

The new Scott campaign commercial contends the cuts are unfair, and Nelson is to blame.

“You pay for Medicare your entire career,” the commercial’s narrator begins. “Your parents pay into Medicare their entire lives. But Washington is letting Medicare crumble.”

The commercial then uses text to cite news reports that predicted that Medicare could face insolvency in 2026.

“Bill Nelson voted to cut $716 billion from Medicare. No wonder it’s going bankrupt,” the narrator continues. “Nelson and the politicians from Washington are stealing from Medicare to pay for other government programs. Stealing from Medicare is unfair.”

Health care advocacy group seeks to ‘correct’ Brian Mast mailer

Liberal action group Floridians for a Fair Shake is out to “correct” a health care mailer sent by incumbent U.S. Rep. Brian Mast.

Mast is a Republican representing Florida’s 18th Congressional District. He recently sent the mailer to voters, touting his record on health care since his election to Congress in 2016.

Not surprisingly, the liberal group, which advocates on issues tied to the health care and economy, had some problems with Mast’s mailer. Jon E. Page, Ed.D., who serves as an advisory committee member for the group, says at the start, “I’m a former teacher and thought I should correct your mailer. It has some mistakes.”

 

For example, Page disputes that Mast’s claim that he sought to “defend care for seniors.” Page notes the GOP health care bill would have allowed seniors to be charged five times more for health care coverage, whereas the Affordable Care Act capped that increase at just three times more.

Some of the group’s “corrections” can be attributed to policy differences, such as criticisms of the GOP bill’s tax breaks.

While Mast and many other Republicans voted to repeal the Affordable Care Act, those efforts ultimately died in the Senate.

Still, the group urges voters to reach out to Mast, highlighting his contact information included in the mailer, and tell him to “save health care and repeal the Trump tax.”

Mast Communications Director Brad Stewart hammered the group in response. “Floridians for a Fair Shake should be honest about who they are: a DC-based dark money group,” said Stewart in a statement to Florida Politics.

“Groups like this that hide their true motives while attempting to deceive voters of a state they don’t even live in is exactly what’s wrong with politics today. While they’re busy ‘correcting’ things they should change their name to Washingtonians for a Fair Shake.”

Stewart also said the original mailer “has every single bullet point sourced to legislation — which is much more than [Floridians for a Fair Shake] can say about their lies.”

Mast is competing for the CD 18 Republican nomination with entrepreneur and teacher Dave Cummings and businessman Mark Freeman. Attorney Lauren Baer and former naval officer Pam Keith are running for the Democratic nomination.

See the Mast mailer, sans corrections, below.

 

Florida Democrats call on Rick Scott to stand up to Donald Trump

Gov. Rick Scott is in Washington raising money for his U.S. Senate campaign, and the Florida Democratic Party says now is as good a time as any to confront Donald Trump for his attacks on health care protections for people with pre-existing conditions.

“According to recent estimates, 7,810,300 Floridians have pre-existing conditions. Those are 7,810,300 of your constituents that could lose their health care if Donald Trump (and your own Attorney General, Pam Bondi) have their way. Yet, despite the potential grave consequences of Trump and Bondi’s lawsuit, you haven’t uttered a word explicitly condemning their actions,” the letter says regarding a multistate lawsuit aimed at removing Affordable Care Act rules guaranteeing health care access for people with pre-existing conditions.

The Trump Administration said earlier this month it will not defend the lawsuit in court.

Scott, in a statement from his Senate campaign last week, said that while “Obamacare is a disaster and costs way too much,” he supports the requirement that health insurers not discriminate against people with pre-existing medical conditions.

He’s yet to back up those words with any action, and that hasn’t gone unnoticed by the Florida Democratic Party.

In an email announcing the letter, the FDP said Scott’s behavior was to be expected, considering he “bragged about crafting the GOP’s recent health care bill that would slash coverage for people with pre-existing conditions (while giving himself a tax break).”

The letter continues:

“Simply put, although we Floridians are tired of your empty rhetoric, we’re also used to it. We know that you have a tendency to say and do anything to get elected. However, in a matter as serious as health care, we hope that you can put aside politics and understand that for many, having access to affordable and quality health care is the difference between life and death.

“On Thursday, while you spend the day hobnobbing with donors in Washington, D.C., we request that you stop by to see your ‘close friend’ Donald Trump and tell him to stop his attacks on health care protections for pre-existing conditions. Or better yet, tell him that Florida is withdrawing as a party to the lawsuit that would make protections for pre-existing conditions unconstitutional.”

The letter is FDP’s latest attempt to turn Trump into an anchor around Scott’s neck. The second-term Republican Governor is challenging incumbent Democratic Sen. Bill Nelson in the fall.

Rick Scott rebuts charges that he’d favor removal of pre-existing conditions coverage

In a statement released by his U.S. Senate campaign, Republican Gov. Rick Scott insisted that he continues to support the requirement that health insurers not discriminate against people with pre-existing medical conditions.

The statement puts Scott at odds with the apparent strategy of President Donald Trump, whose Attorney General Jeff Sessions indicated in recent court filings that the U.S. Department of Justice will not defend the pre-existing conditions coverage guaranteed under federal law through the Affordable Care Act, also known as Obamacare.

It also puts Scott at odds with Florida Attorney General Pam Bondi, who added Florida to a list of states suing in that particular federal court case to get the Affordable Care Act, including the pre-existing conditions provisions, overturned.

Last week Scott also stated he supported non-discriminatory coverage for people with pre-existing conditions, but he declined to discuss the lawsuit.

Democrats have been seeking to tie Scott to Trump. The latest attempt being opposition to the pre-existing conditions law, one of the most popular provisions of ObamaCare. But on Monday Scott delivered a statement refuting that he would support efforts to eliminate the provision, charging that Democrats were doing so falsely.

“My position has not changed – I do not agree with efforts to remove pre-existing conditions,” Scott stated in a news release issued Monday by his campaign. “I’ve continued to say that it is important to cover individuals with pre-existing conditions and that every American, including those with pre-existing conditions, should have the ability to buy any kind of insurance they want. Obamacare is a disaster and costs way too much, but keeping pre-existing provisions should be a part of any healthcare reform. I disagree with efforts to dismantle protections for those with pre-existing conditions.”

Earlier this month, Sessions’ Department of Justice signaled that it would not defend the law’s pre-existing conditions provisions, though U.S. Department of Health and Human Services officials have said they consider pre-existing conditions to continue to be official federal policy.

Florida is among the 20 states that brought that lawsuit against Health and Human Services, and Florida continues to be a party seeking to terminate Obamacare through that suit.

Scott’s opponent in Florida’s U.S. Senate race, incumbent Democratic U.S. Sen. Bill Nelson, and all 11 Florida Democrats in Congress sent a letter to Scott last week urging him to withdraw Florida from the lawsuit, and to support pre-existing conditions.

“Having failed multiple times to rip health coverage away through Congress, the Trump Administration is now attempting to use the court system to take the guarantee of health coverage away from 7.8 million Floridians with pre-existing conditions. This is wrong,” The Democrats’ letter states.

Nelson is meeting Monday morning with constituents with pre-existing conditions to talk about the potential policy change.

Scott’s campaign noted that Florida was brought into the federal lawsuit by Bondi who independently has such authority to do so, and was not brought by Scott.

Scott’s campaign also maintains that his position on pre-existing conditions has not changed, that he has consistently supported keeping them in any health care reform. What Scott seeks, the campaign outlined, is: removing Obamacare’s “excessive mandates and taxes;” allowing insurance to be sold across state lines; preserving the provisions requiring pre-existing conditions and that young adults may on their parents’ plans; and allowing families to buy the healthcare they want.

“It looks like Bill Nelson and his Democratic party loyalists new favorite talking point is an attempt to call out Gov. Rick Scott for not taking a position on preexisting conditions, while ignoring clear and documented evidence to the contrary,” Scott’s campaign stated in a news release.

David Bergstein, spokesman for the Democratic Senatorial Campaign Committee, argued that Scott’s long support for repeal of the Affordable Care Act and his support for last year’s Republican health care plan, which would have cut coverage for pre-existing conditions, bely his stated support for the provision.

“Rick Scott cannot escape his record just because it’s deeply unpopular with Florida voters,” Bergstein said in a written statement. “He spent years opposing protections for pre-existing conditions, and then in 2017 he bragged that he actually helped craft the GOP’s health care bill that would slash coverage for pre-existing conditions while giving himself a tax break.”

Rick Scott treads carefully about Obamacare lawsuit

Despite being a fierce critic of the Affordable Care Act, Florida Gov. Rick Scott isn’t saying where he stands on the Donald Trump administration’s refusal to defend the federal law against the latest legal challenge brought by 20 Republican-led states, including Florida.

Scott on Wednesday avoided directly discussing the litigation, which, if successful, could dismantle changes to how insurance is bought and sold in the state, including eliminating protections for people with pre-existing conditions.

“I believe that if you have a pre-existing condition, you need to still be able to get health care. So it’s very important to me,” Scott, who is running for U.S. Senate, said when asked about the litigation. “I believe everybody ought to be able to get health care insurance.”

Scott, Florida Attorney General Pam Bondi and other Republican leaders have consistently opposed the sweeping health care law — often referred to as Obamacare — that has helped lower the percentage of uninsured citizens in the state and nation.

Florida’s uninsured rate in 2013, the year before Obamacare plans became available, was 20 percent and one of the highest in the nation. In 2016, the rate was 12.5 percent.

Florida also has consistently led the nation in the number of people who enroll in the federal health-insurance exchange under the law. Last year, more than 1.7 million Floridians entered the marketplace to buy a plan. The vast majority, more than 90 percent, received federal financial help to reduce their monthly premiums.

Longtime Florida Republican political consultant Mac Stipanovich said Scott is carefully choosing his positions so he doesn’t alienate Trump supporters while trying to defeat Democratic U.S. Sen. Bill Nelson in the fall.

“You have to be careful about criticizing Trump if you want to continue to enjoy the unreserved support from the Trump base,” Stipanovich told The News Service of Florida.

Bondi signed on this year to the lawsuit challenging the Affordable Care Act. The litigation gained new urgency last week after the Trump administration said it would not defend key portions of the law.

Whitney Ray, a spokesman for Bondi, said the attorney general believes people with pre-existing conditions should have access to coverage.

“But Congress must act in accordance with the U.S. Constitution when addressing the issue,” Ray said in a written statement.

If the suit is successful, it would do away with key parts of the law that require insurance companies to sell health policies to people regardless of pre-existing conditions and prevents charging more because of the conditions. The provisions benefit people who aren’t covered by employer-based plans or Medicaid.

Except for a brief period when Scott supported an expansion of Medicaid, Stipanovich said the governor “has been consistently opposed” to the Affordable Care Act or policies like it.

“I think that is something he cannot deny. And I’m not sure he would deny. Whether it turns out to be important in November or not as opposed to offshore drilling or gun control or immigration is a totally different issue,” Stipanovich said.

Florida Democrats are aggressively trying to make Scott’s opposition to the Affordable Care Act an issue. Democrats in the state’s congressional delegation sent a letter Wednesday to Scott calling on the state to immediately withdraw from the lawsuit, which is led by Texas.

“If successful, this dangerous lawsuit that you and Attorney General Bondi have joined will harm roughly 130 million Americans, including 7.8 million Floridians, who have a pre-existing condition,” the Democratic lawmakers wrote. “And it will take us back to a time when health insurers oftentimes outright rejected, or offered severely limited coverage to, Americans with such conditions.”

Democrats also have launched what they are calling “The Time is Now: Medicaid Expansion Tour” to promote Medicaid expansion in the state. The tour, which started in Gainesville, will highlight how Scott flipped his position on Medicaid.

Scott initially ran for governor in 2010 on an anti-Obamacare platform but said in 2013 he supported a three-year Medicaid expansion and described it as a “compassionate, common-sense step forward.”

During his campaign for re-election in 2014, Scott reiterated his support for the expansion, which was available to all states under the Affordable Care Act. After getting re-elected, though, Scott reversed his position and adamantly fought against efforts by the Florida Senate to expand Medicaid in 2015. The proposed expansion died in the Legislature.

A group called Floridians for a Fair Shake, held a press conference this week to highlight the litigation against the Affordable Care Act because of the potential impact it would have on people with pre-existing conditions. Stephen Gaskill, the group’s communications director, called pre-existing condition protections the most “compelling part of health care reform overall.”

Prior to the federal law, insurance companies could charge higher premiums based on pre-existing conditions or the use of health care services. The federal law also established adjusted community rating, which barred insurers from raising premiums based on health status, medical claims or gender, among other things.

While Scott did not directly address the Trump administration’s actions, he briefly outlined changes he thinks could lower health-insurance costs.

Scott said the changes should be incremental but said he supports “allowing more competition (among insurers), we gotta let people buy the insurance that fits for their family and we’ve got to reward people for taking care of themselves.”

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