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Wednesday, Jun 20, 2018
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Medicaid refusal looms large

The state's decision to reject $51 billion in federal money to expand Medicaid looks more foolish with each passing day. Last week, two health insurance coalitions that represent some of the nation's largest corporations warned that the decision could cost the state thousands of jobs, punish businesses with millions in penalties and ultimately raise insurance premiums for employees across Florida. Gov. Rick Scott, the self-proclaimed jobs governor, needs to use the power of his office to marshal the political support needed to fix this mistake. Scott put the interests of Floridians ahead of politics at the start of the legislative session this spring by acknowledging Obamacare is the law of the land and offering a plan to accept the Medicaid money without committing beyond three years.
He later supported an alternate plan by the state Senate that would have enabled the poor to choose a private health insurance plan and pay a modest monthly premium and co-pays with help from the state using the federal dollars. But the Senate plan was rejected by House Speaker Will Weatherford, who made the specious argument that accepting money to expand Medicaid would deepen the country's debt. He supported a flawed plan to spend more than $200 million in state money to cover a fraction of Florida's uninsured population. The Senate rejected that plan, and the session ended without a way for the state to accept $51 billion in federal money to expand Medicaid in Florida over the next 10 years. Without the money, hospitals and insurers can be expected to pass the added costs on to their insured patients. Some businesses may choose to pull back on hiring, or leave for states with better insurance options. Florida is among 20 states that rejected the Medicaid expansion associated with the Affordable Care Act, known as Obamacare. Accepting the federal money would have cost the state nothing for the first three years, and only 10 percent of the expansion costs thereafter. It would have helped insure close to 1 million of the state's most vulnerable residents and protected businesses from some of the financial penalties associated with the new law. It would have helped with the cost of providing billions in uncompensated care, a huge contributor to rising health-care costs. Now that business coalitions representing companies that include Disney, Target and Wal-Mart have joined with industry associations and hospital operators in calling on the state to accept the federal money, Scott can frame the issue in economic terms. He can make a case that accepting the money could reduce the cost of doing business in Florida, a true conservative tenet. Democrats in the Legislature and U.S. Sen. Bill Nelson have repeatedly called for a special legislative session to pass a Medicaid plan that will bring the $51 billion to Florida. But there is little sense in calling lawmakers to Tallahassee when Weatherford and other conservative House members have given no indication they are willing to change course. Scott should use the economic argument to build a majority consensus in the House that can deliver the votes needed to bring the Medicaid expansion dollars to Florida - if not before the end of this year, then during the legislative session next spring.
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