Florida Legislative Session Ends Without Deal On Medicaid Expansion
By Lynn Hatter, WFSU
May 03, 2013 - Kaiser Health News
The question of whether Florida would expand its Medicaid program to cover
more low-income people has been answered, and itfs a gnoh — at least for now.
The state Legislature closed its regular session Friday without reaching an
agreement to expand access to the program under the Affordable Care Act.
To be revived in the near term, Gov. Rick Scott would have to call a special
session of the Legislature. There has been no indication that he is willing to
do that – or that he is close to a deal with state House Republicans that would
warrant such a session.
Scott, a Republican, stunned supporters and critics
alike in February when he flipped from being a staunch opponent of the federal
health law to endorsing
its Medicaid expansion.
The health care overhaul gives states the option to expand their existing
Medicaid programs with the federal government footing the full cost of the
expansion in the first three years and paying 90-percent thereafter. In Florida,
the raw numbers were persuasive to Scott, who is a former executive with
hospital giant, HCA. Medicaid expansion would bring $50 billion in federal money
to the state over the next ten years and cost Florida $3.5 billion in the same
time frame.
State Sen. Joe Negron, a Republican, was the architect of a bill that passed
the Senate. He laid out the differences between members of the two chambers
within his own party.
gI have a view that when it comes to providing health care to people who get
up and go to work every day, there is a role for government to provide
assistance for their premiums,h Negron said. gAnd in the House, therefs a
concern that wefre becoming too reliant on federal funds and [that] we could be
setting up a program thatfs too expensive for us to afford.h
Negronfs
proposal, which is similar to a plan that has
passed in Arkansas, would use the federal money to help eligible Floridians
purchase private plans. That was a non-starter for House Republicans. Instead
House lawmakers pitched a separate plan to insure far fewer people using state
funds. The back and forth between the two sides got heated, culminating in a
protest by House Democrats that required every single bill to be read aloud
before the chamber, line-by-line, and in full. That prompted Republicans to
employ gMaryh the Housefs auto reader, stalling all House business for two days
as "she" read.
At one point, there were talks of a compromise between the two chambers.
But Senate
President Don Gaetz said, gIt appears the shot-clock has run out on the
health care issue for this session. But that doesnft mean wefre going to stop
working.h
Nearly 4 million people, or about one in five Floridians, are uninsured. An
expansion of the Medicaid program, or some kind of alternative, could cover up
to a million of the uninsured. Florida Hospital Association President Bruce
Reuben says accepting the federal money would reduce the costs of treating the
rest of the uninsured.
gEven if we did nothing, wefd still be paying for the cost of care for these
people,h Reuben said. gWefd simply be paying for it through a hidden tax, a cost
shift onto peoplefs private health insurance premiums.h
U.S. Rep. Debbie Wasserman Schultz, who is Chairwoman of the Democratic
National Committee and who represents the Fort Lauderdale area, criticized Scott
for his inaction.
gIt seems to me hefs sitting on the sidelines trying to have his cake and eat
it too,h said Wasserman Schultz. gYou canft have it both ways. Youfre either for
it or youfre against it, and in Tallahassee you have to take a stand.h
For states that have taken action, the Medicaid expansion goes into effect in
January. If Florida waits until next year to expand the program, it would lose
some of the federal money it would otherwise have received. States do not have a
deadline when they have to accept or permanently reject the expansion.
There is precedent for states jumping in late to government health programs.
Florida adopted the main Medicaid program in
1970, four years after it began.
This story is part of a reporting partnership that includes WFSU, NPR and Kaiser Health News.
© 2013 Henry J. Kaiser Family Foundation. All rights
reserved.