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

Kevin McCarty, state insurance commissioner, said at a meeting last Tuesday that the Patient Protection and Affordable Care Act “is not now in effect in Florida” in the wake of Judge Roger Vinson’s Monday decision.

Mr. McCarty said he is temporarily suspending an application for a waiver/adjustment from new health insurance medical loss ratios.

“We are going to take stock and see what our options are,” he said during a meeting of the Florida Health Insurance Advisory Board (FHIAB).

Mr. McCarty said he told Jay Angoff, director of the HHS Office of Consumer Information and Insurance Oversight, that Florida would not be spending any of the funds it had been allocated to implement the insurance exchange program.

He said at the meeting that he had concerns about possible inappropriate federal interference with Connecticut in implementation of the exchanges and “yesterday’s decision just made it a cinch.”

Rick Scott, the state’s governor, confirmed that, “We’re 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.”

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 Scott also said, “And I hope and I believe that either it will be declared unconstitutional or it will be repealed.”

At the same time, several lawyers who declined to be named said their interpretation of the federal Rules of Civil Procedure provide that the judge’s ruling cannot be enforced for 14 days after entry of judgment. 

The lawyers said that the U.S. government will have no choice but to seek a “stay,” especially if other states follow suit. They suggested that if the U.S. does not move for a stay, and if the Department of Health and Human Services continues work on implementation, an opponent of PPACA could seek to get a federal court to cite Secretary Kathleen Sebelius for contempt.

The implementation issue is arising because of the way Judge Vinson 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 the improper and the able-to-stand-alone from the unable-to-stand-alone.”

He therefore issued a declaratory judgment against the entire law and suggested that the Obama administration view it as the “functional equivalent” of an injunction to suspend its implementation.

At the Florida hearing, Deputy Insurance Commissioner Mary Beth Senkewicz said that in the wake of the decision, the new MLR requirements and other provisions of PPACA are not constitutional in Florida.

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