State lawmakers, including Republican Florida House Speaker Will Weatherford, have said they will not accept any of the Medicaid expansion money for ideological reasons. (Photo by Gage Skidmore.)

By Ashley Lopez
Florida Center for Investigative Reporting

Florida’s 2013 legislative session ended last week without state lawmakers agreeing on a plan to accept federal money for expanding Medicaid in the state. Now, Democrats are asking the governor to call a special session to work out a deal.

The U.S. Supreme Court ruled last year that states could opt out of a provision in the 2008 health care reform law that requires expansion of Medicaid coverage to the working poor — which in Florida includes about 1 million people. For the first few years, the federal government would pay for 100 percent of the expansion’s costs.

Florida Republicans have taken a hard line against every provision in the federal health care law since it passed three years ago, and not much is different with the Medicaid provision. State lawmakers, including Republican Florida House Speaker Will Weatherford, have said they will not accept any of the money for ideological reasons. That’s why the Florida House offered a health insurance plan that would cover significantly fewer people and could end up costing the state a lot of its own money.

Republican Gov. Rick Scott criticized the House’s plan. Scott spent the beginning of his political career challenging the health care law, but he has recently advocated for expanding Medicaid in the wake of President Obama’s reelection.

The Florida Senate was able to find some middle ground and proposed accepting the federal money but giving it to families to spend on private insurance — a plan that received approval from Democrats in the Legislature as well as Gov. Scott.

But the two chambers failed to reach a compromise before the end of the legislative session.

According to Lynn Hatter of WFSU:

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 “Mary” the House’s 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, “It appears the shot-clock has run out on the health care issue for this session. But that doesn’t mean we’re going to stop working.”

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.

“Even if we did nothing, we’d still be paying for the cost of care for these people,” Reuben said. “We’d simply be paying for it through a hidden tax, a cost shift onto people’s private health insurance premiums.”

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.

Despite the lost opportunity during this session, Scott could still call a special session for lawmakers to work out a deal.

As The Miami Herald/Tampa Bay Times reports, however, a special session remains unlikely unless lawmakers in both chambers show an interest in coming up with a plan:

Neither Scott nor Senate President Don Gaetz have said they would support reconvening the Legislature to address the issue.

House Speaker Will Weatherford was cool to the idea when theTimes/Herald spoke to him on Monday.

“I don’t know what it would achieve,” Weatherford said. “Unless there was an agreement of what the session would do, calling one doesn’t make sense. We would have to have some agreement on policy, other than drawing down on federal funds.”

Weatherford would not say what type of alternative plan he thinks would make a special session a good idea.

Scott may not be keen on calling a special session if he’s not assured the Legislature is ready to compromise. In 2010, the Florida House famously adjourned a special session convened by then-Gov. Charlie Crist after only 49 minutes of work, rejecting his proposal to initiate a ballot referendum on offshore drilling.

Democratic state lawmakers, along with U.S. Sen. Bill Nelson, a Democrat, have called for a special session.

According to the Herald/Times:

U.S. Sen. Bill Nelson and the 14 Democratic members of the Florida Senate sent separate letters Monday making the request, following House Democratic leader Perry Thurston’s request for one Friday …

In his letter, Nelson said Scott had a moral duty to urge the Legislature into action. “Your announcement last February — when you publicly declared you wouldn’t be the one to ‘deny’ these Floridians this coverage — was seen by many as a ‘watershed moment’ for the nation’s health-care bill,” Nelson wrote.

“Now, the Legislature has done exactly what you said you wouldn’t: it has denied these Floridians access to coverage. And now, only you have the chance to remedy the lawmakers’ failure to expand Medicaid to these needy Floridians.”

Although Gov. Scott has endorsed the state’s approval of the Medicaid funds, he did not make Medicaid expansion a legislative priority this year. Instead, Scott threw support behind a manufacturing tax break and teacher pay raises — both of which passed.