Florida has shut down its implementation of the health carereform law as a result of a decision early last week by aPensacola federal judge declaring the law unconstitutional.

Kevin McCarty, state insurance commissioner, said at a meetinglast Tuesday that the Patient Protection and Affordable Care Act"is not now in effect in Florida" in the wake of Judge RogerVinson's Monday decision.

Mr. McCarty said he is temporarily suspending an application fora waiver/adjustment from new health insurance medical lossratios.

"We are going to take stock and see what our options are," hesaid during a meeting of the Florida Health Insurance AdvisoryBoard (FHIAB).

Mr. McCarty said he told Jay Angoff, director of the HHS Officeof Consumer Information and Insurance Oversight, that Florida wouldnot be spending any of the funds it had been allocated to implementthe insurance exchange program.

He said at the meeting that he had concerns about possibleinappropriate federal interference with Connecticut inimplementation of the exchanges and "yesterday's decision just madeit a cinch."

Rick Scott, the state's governor, confirmed that, "We're notgoing to spend a lot of time and money with regard to trying to getready to implement that until we know exactly what is going tohappen."

Gov. Scott also said, "And I hope and I believe that either itwill be declared unconstitutional or it will be repealed."

At the same time, several lawyers who declined to be named saidtheir interpretation of the federal Rules of Civil Procedureprovide that the judge's ruling cannot be enforced for 14 daysafter entry of judgment. 

The lawyers said that the U.S. government will have no choicebut to seek a "stay," especially if other states follow suit. Theysuggested that if the U.S. does not move for a stay, and if theDepartment of Health and Human Services continues work onimplementation, an opponent of PPACA could seek to get a federalcourt to cite Secretary Kathleen Sebelius for contempt.

The implementation issue is arising because of the way JudgeVinson worded his decision.

He compared the law to "a finely crafted watch" where there were"too many moving parts" for him to "dissect out the proper from theimproper and the able-to-stand-alone from theunable-to-stand-alone."

He therefore issued a declaratory judgment against the entirelaw and suggested that the Obama administration view it as the"functional equivalent" of an injunction to suspend itsimplementation.

At the Florida hearing, Deputy Insurance Commissioner Mary BethSenkewicz said that in the wake of the decision, the new MLRrequirements and other provisions of PPACA are not constitutionalin Florida.

She said this would change if the White House appeals thedecision to the 11th Circuit Court of Appeal and secures a stay ofthe Pensacola court's ruling.