TALLAHASSEE — Gov. Rick Scott slammed a Florida House proposal today that would pass up billions of federal dollars to provide health care coverage to 115,000 uninsured Floridians in a watered down alternative to expanding Medicaid under the federal health law.
The proposal relies entirely on $237 million in state taxpayer funds and would not tap into an estimated $51 billion dollars in federal aid available under the Affordable Care Act over the next decade.
It would also offer coverage to thousands fewer residents, covering only those making 100 percent of the federal poverty level as opposed to the roughly 1 million residents that would have been covered through Medicaid expansion.
The Obama administration has sought to increase health coverage to more Americans by expanding Medicaid to those making up to 138 percent of the poverty level — something many state GOP lawmakers are opposed to.
Instead, House Republicans plan to expand a health insurance program pushed by former House Speaker Marco Rubio that would give residents state money to help them obtain coverage from the private insurers through the online health exchange. Rubio's plan — known as Florida Health Choices — has had trouble getting off the ground and currently doesn't insure anyone.
“The House's plan will cost Florida taxpayers on top of what they are already taxed under the President's new healthcare law. This would be a double-hit to state taxpayers,” Scott said in a statement.
Scott made an about-face decision earlier this year saying he supported Medicaid expansion because it was the compassionate, common-sense approach, but he's said he's open to alternatives after committees in both the House and Senate rejected expanding Medicaid. Scott signaled today he would support a Senate plan proposed by Sen. Joe Negron “because it protects both state taxpayers and the uninsured in our state.”
Negron's bill would still tap into billions of federal dollars and use those funds for vouchers so patients could purchase private health insurance. His plan would utilize Florida Healthy Kids, an organization he says has a strong record with the state,
But it's unclear whether the House will be open to any health plan that relies on federal funds, worrying that if they expand the program the federal government will not make good on its promise to fund it. The federal government has promised to foot the entire bill for three years and 90 percent after that. That's a much better deal than the state currently has for Medicaid patients, with the feds paying roughly half.
House Republicans also contend Medicaid is a broken system with poor health outcomes and weak access to doctors and specialists.
“The Florida House has developed a plan that will fit the needs of Florida, not the requirements of Washington,” said House Speaker Will Weatherford. “Our plan increases our commitment to a strong safety net and ensures Floridians are not on the hook for billions that we currently do not have.”
The House proposal is similar to another plan in the Senate by Sen. Aaron Bean, R-Fernandina Beach, who also wants to rely on state dollars. But the House plan is more comprehensive and would offer coverage to disabled adults and adults with children. Most of the plans would provide low-cost preventative and primary care visits, subsidized by state funds.
Angry House Democrats have said finding an affordable way to expand health coverage is still do-able even though the Legislative session is past the midpoint.
House Democrats felt so strongly about the health care decision they initially agreed to withhold their support for the House's proposed $74 billion budget to signal their strong advocacy for action.
“Though personally, at first glance, I am not enthralled by the proposal, I recognize that it is at least a minimal attempt toward achieving a legislative compromise on the important topic of health coverage for Floridians,” House Democratic Leader Perry Thurston, D-Fort Lauderdale, said in a statement.
But shortly after the House proposal was released, Thurston said he went to fellow Democrats and said they should vote on the budget as they deem appropriate.
Weatherford has said that while House Republicans are dead set against Medicaid expansion, he's not ruling out an alternative plan. But he said he's not enthusiastic either. He's also reiterated concerns that the feds won't pay their share of the deal, leaving the state on the hook for future costs.
During today’s question time on the floor, Rep. Mark Pafford alluded to Medicaid expansion, asking House budget chief Seth McKeel about Medicaid funding generally.
Pafford, a West Palm Beach Democrat, asked whether there was any contingency plan if the federal government reneged on giving Florida its share of Medicaid money.
Finally, he asked, “Has the federal government ever not paid its Medicaid commitment?”
McKeel responded that if the feds change the matching rate, then the answer could be yes.