Three states have exercised their legal right to opt out of two key provisions of the Patient Protection and Affordable Care Act.

Florida just joined Louisiana and Wisconsin in electing not to create private health insurance exchanges designed to help state citizens find affordable coverage.

The three states have also elected not to expand their Medicaid programs to provide more coverage for the poor, a move that became more possible by the Supreme Court in the same decision that kept the healthcare reform law intact.

In its decision to uphold the reform law in its entirety, the High Court ruled the federal government could not cut off federal money paid to the states for Medicaid programs in an attempt to get them to comply with the expansion.

Once the Supreme Court upheld the law, Louisiana and Wisconsin immediately announced they wouldn’t implement the two provisions.

Florida, however, didn’t make similar declarations until just recently.

While each state is required to have its own health insurance exchange, they are not required to set them up themselves. The reform law mandates that if states do not create them, the federal government will.

As for Medicaid’s expansion, Florida has said it would cost more than the state is willing to take on, despite the feds willing to pick up 90% of the tab. It also said it has other state programs that already provide similar coverage options.

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