This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.
Florida's governor and legislative leadership declined to participate in setting up an Affordable Care Act (ACA) exchange and, indeed, refused or returned federal grants awarded to facilitate exchange planning. Instead, the state provided funding for an existing state-funded exchange for small business and individuals unrelated to the ACA that opened with limited services in spring 2014. Florida led the way in opposition to the ACA. Its then attorney general, Republican Bill McCollum, filed suit against the Obama administration aiming to have the law blocked as unconstitutional in both its individual mandate and its requirement for Medicaid expansion.