Fla. Senate panel rejects Medicaid expansion
Published: Monday, March 11, 2013 at 3:15 p.m.
Last Modified: Monday, March 11, 2013 at 3:51 p.m.
TALLAHASSEE — Republican legislative leaders have lined up in opposition to Gov. Rick Scott's plan to expand Medicaid in Florida under the federal Affordable Care Act. With the party line vote Monday by the Senate special committee looking at the federal health care law, it would seem that Scott and Medicaid expansion are the immediate losers.
But that is not necessarily the case. Scott and the proponents of Medicaid expansion may still emerge with something by the time the 2013 Legislature concludes in early May. What that partial victory will look like is far from clear.
The game is still on because the stakes remain high, with more than $50 billion in potential federal funding over the next decade and the prospect of providing health insurance to nearly 1 million Floridians.
On Monday, Sen. Joe Negron, R-Stuart, chairman of the select committee and Senate budget chairman, outlined a plan that would use the promise of additional Medicaid spending in Florida to provide private insurance to low-income residents.
"I oppose the Washington plan and I want a Florida plan," Negron said. "I think we have an opportunity to build a better program than what Washington is trying to force on us."
Negron's still-evolving plan would be similar to a Medicaid expansion plan being advanced in Arkansas. But Negron said it would be different in that Florida would not use federal insurance exchanges for the policies but would use an existing state insurance program for low-income families — Florida Healthy Kids — to provide the coverage.
Negron said his eventual goal would be to end Medicaid "as we know it" in Florida and replace it with government subsidies for private coverage, although he conceded that ambitious plan would likely take years to bring about. He also said Medicaid recipients would have to pay something for their care on a sliding scale based on their income.
But veering off from the traditional Medicaid program will likely require Florida to receive federal approval for the variation — a prospect that could take some time.
The result is the future of Medicaid expansion in Florida is muddled at best. It has even led to some confusing political spin.
Senate Democrats released a statement characterizing the Senate's action as an "endorsement" of expansion.
"Although Republicans voted against what they called ‘traditional Medicaid expansion' they turned around and endorsed a program that still relies on the same federal dollars and still extends affordable health care to 1 million Floridians," Sen. Chris Smith, D-Fort Lauderdale, said in a statement.
"Whatever name they opt to give the program, the bottom line is that money allocated by the federal government for Medicaid expansion will be the mechanism. In the Senate, the remaining question is no longer ‘if,' but ‘who,' " he said.
Yet at the same time, Florida Democratic Party Chair Allison Tant released her own statement characterizing the Senate's decision as "doubling down" on a Republican "crusade against affordable health care."
"The move was another stunning rebuke of Gov. Rick Scott and the common sense policy that ensures more Floridians have access to the health insurance coverage they need," Tant said.
Tant also chided Scott for not making a stronger push for the expansion, saying he "has failed at every turn to show leadership on this issue."
Yet Scott indicated the fight isn't over.
"I am confident that the Legislature will do the right thing and find a way to protect taxpayers and the uninsured in our state while the new health care law provides 100 percent federal funding," Scott said after the Senate's decision.
Even if lawmakers ultimately reject any type of expansion, Scott may be able to deflect some — if not all — of the blame on the Legislature. It will be the lawmakers' decision, not his, to turn aside some $51 billion in federal Medicaid funding over the next decade, which would have to be matched by $3.5 billion in state funding.
Scott has only recommended expansion for the first three years, which would be fully covered by federal funding.
The state has been weighing the prospect of expanding Medicaid coverage to all Floridians who earn less than 138 percent of the federal poverty level, which is $26,344 for a family of three.
The House leadership rejected the Medicaid expansion just as lawmakers began their annual session last week.
But House Speaker Will Weatherford, R-Wesley Chapel, who reinforced that rejection in his opening-day speech to his chamber, seemed to offer some room for an "alternative" Medicaid plan in his reaction to the Senate's decision.
Weatherford praised the Senate committee for its "thoughtful and deliberative approach."
"Like the House, the committee gathered the facts and decided that Washington's inflexible approach to force Florida to take a ‘one-size fits all' policy choice is not in our state's best interest," Weatherford said.
But he also said he would work with Senate President Don Gaetz, R-Niceville, to "investigate alternatives that will strengthen the (health care) safety net," while curbing Medicaid spending so that it doesn't put other areas of the state budget "at risk."
Gaetz said the Senate would work with the House on providing "private insurance options, not government-run health care as a replacement for traditional Medicaid."
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