Medicaid expansion in Florida is still on shaky ground. (Photo via Jimmy Emerson)
By Ashley Lopez
Florida Center for Investigative Reporting
Despite reporting that there is some effort to get Florida Republicans to accept federal dollars to expand Medicaid coverage to about a million people in the state, lawmakers and experts say this part of the Affordable Care Act still faces a tough fight in the Florida Legislature.
A few days ago, The Guardian reported that there were “secret” talks aimed at brokering a deal that would end with state lawmakers accepting the billions of dollars earmarked for the state to expand its Medicaid to more people. According to The Guardian:
Secret conversations are taking place in Florida between healthcare stakeholders and the legislature that will most likely lead to the Republican-controlled state accepting Medicaid expansion money, according to senior figures in the health industry.
Some health professionals believe the amount of money on offer and the fact that the Republican party benefits from campaign contributions by the health insurance industry means that Florida is likely to find a way take the funding provided by the Affordable Care Act.
It would join a number of states with Republican-dominated legislatures, including Arkansas, Iowa and Wisconsin, to exploit a provision in the ACA that allows them to take the additional cash by providing an alternative to the public Medicaid program.
Donna Shalala, secretary for health and human services under Bill Clinton and now president of the University of Miami, told journalists at a meeting convened by the Kaiser Family Foundation in Miami this week that Republicans in the state would find a way to get over their political opposition to the ACA, also known as Obamacare.
However, WFSU followed up with some state lawmakers close to this issue– and according to some leaders in the legislature, there aren’t any such talks. WFSU’s Lynn Hatter reported:
Florida legislative leaders are downplaying an article in London’s Guardian newspaper that says the state is in talks to expand Medicaid. The article cites “secret negotiations,” but state officials say they’re not happening.
… “The legislature’s decision last session not to expand Medicaid under the Affordable Care Act was made deliberatively and thoughtfully and since then, nothing has changed,” said Representative Richard Corcoran (R-Land O’Lakes) in a written statement. “The Florida House would welcome any talks providing Florida the flexibility to spend tax dollars more wisely and has no interest in expanding Obamacare under its current inflexible and irresponsible terms.”
House Minority Leader Perry Thurston backed up Corcoran, saying aside from the Guardian report, he wasn’t aware of any negotiations to expand Medicaid.
“However, I am hopeful that Republican legislative leaders and Governor Rick Scott will recognize the profound need, and will take positive bipartisan action, to reduce the high number of uninsured Floridians,” he said in a statement.
Last legislative session, Gov. Rick Scott announced he supported accepting the federal money to expand Medicaid. However, conservative leaders of the GOP-dominated Florida House voted down the expansion. Scott, who began his political careering railing against the Affordable Care Act through a political action committee he created, did not lobby state lawmakers leading up to the vote and has generally not been very vocal about his support for Medicaid expansion.
Even though the Florida House has been unflinchingly against expanding Medicaid, the more moderate Florida Senate worked up a plan that included accepting the funds to then pay for private insurance for those eligible for Medicaid under the expansion.
However, most House leaders were unwilling to consider the Senate’s plan– and it seems like that is where things have stayed.
Most recently, The Miami Herald reported that Scott’s health care policy advisor doesn’t think it’s likely that the state will chose to expand Medicaid. According to The Herald:
“My name is Alan Levine. I’m a conservative,” the head of Health Management Associates introduced himself Thursday to a group of healthcare journalists in Doral. Who better than the Republican party healthcare guru to forecast the state’s chances of expanding Medicaid?
“Very low,” was Levine’s take on those chances, and, on further prodding, “less than 30 percent.”
Timing is one of the biggest reasons for his low vote of likelihood. With upcoming elections and the fumbles of the Affordable Care Act’s launch, Republicans think they have the upper political hand to stay their course of resistance to Medicaid expansion, even if it means forfeiting billions of federal funds and hurts the poor.
Another reason is the distrust with which state conservatives hold the Obama administration, although the reasons are laced with political hyperbole. “We were never invited to the table,” Levine said of Democrats’ healthcare initiatives since the late Sen. Ted Kennedy.
Many health experts have said not expanding Medicaid would leave out hundreds of thousands of the poorest people in the state from being included in the Affordable Care Act. While most people will gain insurance, many of the state’s most vulnerable residents will still be left behind.
Besides that, the law also phases out funding for hospitals that treat people without insurance. If the state does not accept the Medicaid dollars, it could level a serious financial blow to many of the states hospitals.