The Senate Select Committee on Patient Protection and Affordable Care Act (PPACA) held its first meeting on Monday, as the Legislature begins to examine if and how Florida will implement certain provisions of the federal health care law. Specifically, the committee is tasked with responding to two key aspects of the legislation: 1) establishing a health insurance exchange, which is a required component of the law; and 2) the option to expand Medicaid coverage to Florida residents who fall below 138% of the federal poverty level. With regard to setting up a health care exchange, the states have the option to create a state-based exchange, a federally-facilitated exchange, or a federal/state partnership exchange. Florida has not yet declared which type of exchange it will pursue. States have until December 14 to notify the federal government of their exchange plans. The House Select Committee on PPACA has not yet met. FAC will be monitoring these committees very closely, particularly their decisions on Medicaid expansion, as we continue efforts to reform the existing county-state Medicaid cost sharing relationship.