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Friday, Jun 22, 2018
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The business case for expanding Medicaid

The Florida Chamber of Commerce, the Florida League of Women Voters, the Florida Hospital Association and many other business associations are calling on Florida’s leaders to expand insurance coverage for the economic health of Florida.

The business case for decreasing the number of Floridians without insurance is overwhelming.

More than one in five Floridians lack health insurance, with the number growing. In the past, most people obtained insurance through their employment. However, for the past decade, many employers have cut back on providing health insurance.

Today, 80 percent of Floridians who are uninsured have a family member who is working. In 60 percent of those homes, someone is working full time. More and more, people find it impossible to purchase health insurance even when employed, and one major illness can drive a family into bankruptcy.

By failing to reach agreement on expanding insurance coverage, Florida is leaving $51 billion in federal dollars on the table. This money will go to other states to expand their insurance programs and will, at the same time, improve the economic health of the health industry in those states.

Health care providers, particularly hospitals, are drowning in red ink from the cost of providing charity care for the uninsured. These same health-care providers are the economic foundation of many communities in Florida.

As an example, Tampa General Hospital employs 6,600 people, making it essential to the economic health of the Tampa Bay area. States and localities compete for jobs on many levels. Increasingly, that competition is fought not only on the quality of schools and roads, but on the condition of a health sector that can protect health and generate jobs.

Recently, Gov. Rick Scott came to Tampa to celebrate the announcement by a local company that it will add more than 1,000 jobs to the Tampa economy over the next few years. Those jobs are in response to the demands of the Affordable Care Act.

As the Florida Legislature prepares for a new session, it confronts perhaps the most pressing issue facing all states: Should it expand Medicaid to conform to the requirements of the Affordable Care Act? Does expansion have to be through Medicaid? No. In the last session of the legislature, Sen. Joe Negron proposed a creative plan to expand coverage to many Floridians through a privately administered plan. This is an approach other states are taking as well, and the federal government appears amenable to such approaches as long as coverage is truly expanded.

When Medicare — health insurance for persons over 65 — was first proposed, it was denounced by the American Medical Association, among others, as a socialist takeover of medicine. Today, any plan to eliminate Medicare would be viewed as a fundamental assault on the American health-care system.

Yes, the Affordable Care Act has flaws, and Medicaid is a far from perfect system. However, there are alternatives that achieve the same public policy goal of increasing insurance coverage, something that Sen. Negron’s proposal demonstrates.

Catastrophic illness does not recognize political party, nor does it recognize wealth. The lack of insurance coverage not only kills individuals and bankrupts families, it can do immeasurable harm to the economic interests of a community and its quality of life.

John Petrila, J.D., is a professor at the University of South Florida College of Public Health in Tampa.

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