2013-03-15 08:00:00

Door Not Yet Shut on Florida’s Medicaid Expansion

Photo: Courtesy FL CHAIN

Florida’s Republican Governor Rick Scott, reversed himself last month and said his state would expand Medicaid and enact President Obama’s health care reform law. It would provide coverage to an estimated 1 million more low-income Floridians. But a Florida Senate committee voted this week to reject expansion. The decision reinforces one by Florida’s House, which rejected expansion the week before.

Under the Affordable Care Act (ACA), states that agree to add lower-income, uninsured people to their Medicaid rolls will receive 100 percent of the additional cost in federal dollars for three years starting in January 2014, and 90 percent for subsequent years.

Opportunities for further debate and legislative action on this issue will end on May 3. That’s when the
Florida Legislature, which serves 19.4 million people, concludes its annual session in Tallahassee of only 60 days per year, unless the governor or three-fifths of the legislature decided to call a special session.

New America Media spoke with health care policy experts and advocates in Florida regarding what they make of these recent decisions and what they see in their state’s future for heath care access.

Nick Duran, Health Care Coordinator, the Children's Movement of Florida, Miami:

I was cautiously optimistic at what was going to happen. Although it was disappointing that the Senate did not go ahead with the Medicaid expansion, there were several members who did allude to the federal dollars the state would get and seemed interested in getting those dollars to implement some Medicaid expansion.

There seems to be a lot of discussion now, and you see it on a national level, for example, the unique approach to Medicaid expansion in Arkansas. [Note: The Obama Administration has approved the proposal by Arkansas’ Democratic Governor Mike Beebe to offer coverage to low-income Arkansas residents through private insurers.]

What we saw is a mirrored expression of interest in that as well. Are we going down that same path--who knows?

But the door has not been shut, the discussion continues. There is still a lot of work to be done by advocates, experts, by the legislators. As long as those conversations continue, I am hopeful. I believe that [Florida] Sen. Simmons, who has opposed the expansion, said that our business are going to be impacted if we don’t move forward with Medicaid expansion, if we don’t take these federal dollars and do something. We cannot do nothing.

If there was a takeaway from the vote it’s that they aren’t interested in Medicaid expansion in its current form, but they are interested in something. So what that something will be is yet to be determined.

Karen Woodall, Executive Director, Florida Center for Fiscal and Economic Policy, Tallahassee, Fla.

Those who voted no said, “I am only voting no because I understand and trust that the chairman, Sen. Negron, wants to look at alternatives to traditional Medicaid.” They are still opposed to Obamacare, but they are also saying. “We understand that we have a million people who would benefit from this. And the majority of them are working, but don’t have health insurance. We don’t want a Washington solution, we want a Florida solution.”

What this means is that they are keeping the conversation alive. We expect that this issue is going to drag out until the end of session. Some of the things they are talking about will have to get special permission from Washington, from the Center for Medicaid and Medicare Services.

What is important is that we look at how we are going to provide quality, affordable health insurance to over a million Floridians? How we are going to utilize the federal dollars, which we have already paid for and that are set aside for Florida. How we are going to bring those dollars back into the state, so people get coverage--and we create jobs?

From an advocacy stand point it’s important for people in communities who are uninsured, who know people without insurance or don’t have good benefits, to keep calling their legislators, the governor, the president and the speaker of the house. They need to hear, “We want you to expand Medicaid.” They need to hear that Floridians want Medicaid expansion, which is 100 percent funded with federal dollars.

Those are our tax dollars that we pay in income tax. The first three years are 100 percent covered. After the three years, over a 10 year period, we would pay a little more (the most will be 10 cents on the dollar).

So the notion that Florida can’t afford Medicaid expansion is ridiculous. We pay for uninsured people everyday in emergency rooms--and we pay a lot more.

Leah Barber-Heinz, Advocacy Director, Florida Community Health Action Information Network (FL CHAIN), Jupiter, Fla.

We are in a waiting mode to see exactly what this proposal would look like. We do feel hopeful and are moving forward with our coalition efforts to continue talks about this issue and press as hard as we can to tell the personal stories of the uninsured, and who this would impact.

There is nothing solid yet. If they are going to stay within the federal standards under the ACA and draw down the monies that were meant for the one million uninsured in Florida, then we would be interested to see what it looks like.

We have a very broad-based coalition that is growing by the minute, because people really understand that this makes sense for Florida--for the uninsured; for the economy; for the business and industry sector.

I’m hoping that the lawmakers do the right thing for Florida. I hope that no matter what the alternatives may look like in the end, what it means is coverage for 1 million more Floridians.

This article is part of ongoing coverage by New America Media on the Affordable Care Act, supported by The Atlantic Philanthropies.

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