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Sunday, Apr 22, 2018
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Florida should take the $51 billion in Medicaid money

One million of Florida’s poorest residents are eligible for health insurance under the expanded Medicaid income guidelines associated with the Patient Protection and Affordable Care Act.

But many of them will be relegated to the sidelines as enrollment begins Oct. 1 in the health-care marketplaces being formed under the new law, known as Obamacare.

That’s because the state House, under the leadership of Speaker Will Weatherford, refuses to budge on a decision last spring to reject $51 billion from the federal government to expand Medicaid in Florida over the next 10 years.

We call on Weatherford, and Gov. Rick Scott, to re-evaluate that decision now that the state’s business leaders and major health-care providers are pleading with them to reverse course and take the money.

Those pleadings were joined by some prominent Tampa voices last week: Bob Rohrlack, head of the Greater Tampa Chamber of Commerce; John Petrila, chair of the University of South Florida College of Public Health; and Jim Burkhart, president of Tampa General Hospital.

“Sit down with us and work with us and let’s work out a solution,” Burkhart said at the press conference organized by the League of Women Voters last week. They were speaking indirectly to Weatherford, Scott and lawmakers who will be gathering in Tallahassee this week for committee meetings in advance of the legislative session that starts in March.

Weatherford responded by saying the uninsured deserve private health care, not “government-run” health care. He thinks the Medicaid expansion under Obamacare will expand the country’s deficit, and that the federal government can’t be trusted to fully fund the program going forward, leaving Florida on the hook sometime down the road.

State Rep. Matt Hudson, a Republican from Naples who testified last week before a congressional committee investigating the effects of Obamacare on the states, says the expansion won’t lessen the number of uninsured, will strain an already lean health care workforce, and will add to the borrowing the federal government must undertake to pay its bills.

We respect their concerns about federal spending, and we think Obamacare is deeply flawed, but their arguments are not persuasive enough to deny as many as 1 million of the state’s most vulnerable residents a chance at health insurance.

Studies vary on what Medicaid expansion will do the deficit. In fact, the federal government’s Congressional Budget Office estimated it will reduce the deficit when all of its provisions are fully realized. If the state rejected every program operating with federal dollars because it feared those dollars would dry up, the state might come to a standstill. The poor should not be denied insurance because they might further stress the health care system in Florida.

We’re talking about a family of four living on less than $32,500 a year, and individuals living on less than $15,000 a year. Rejecting the money also flies in the face of studies that show the Medicaid money will create jobs and help ease the burden on hospitals that provide billions of dollars in uncompensated care, a major contributor to rising health care costs. Much of the costs of that charity care is now shifted to businesses and individuals with insurance.

A University of Florida study estimates the Medicaid expansion would create 120,000 jobs in Florida over the next 10 years, with about 7,400 of those in Hillsborough County. In June, two health insurance coalitions representing some of the nation’s largest corporations — including Disney, Target and Wal-Mart — joined with industry associations and hospital operators in warning the state that rejecting the money could cost jobs and ultimately result in rising premiums for employees across Florida.

A reasonable compromise was floated during the last legislative session, a state Senate plan that would have used the federal Medicaid money to enable the poor to obtain private insurance with modest monthly premiums and co-pays.

It was a compromise that satisfied the governor and the Senate but was rejected by the House, which offered a plan to spend state tax dollars to insure only a portion of the 1 million poor who might get insurance under the Medicaid expansion.

At the press conference in Tampa last week, that Senate plan was invoked by local leaders who think it offers a viable alternative. We agree and urge House leaders to reconsider that plan, or fashion a reasonable compromise that covers the poor and delivers the $51 billion.

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