TAMPA — A White House report says failure to expand Florida’s Medicaid program under the Affordable Care Act will cost the state nearly 64,000 jobs in the 2014-16 period, leave 850,000 people uninsured who would otherwise have coverage and nearly 160,000 facing financial problems because of inability to pay medical bills.
The report, from the White House Council of Economic Advisers, titled “Missed Opportunities,” said the economic effects will result from the loss of federal spending that would have come along with expansion of the Medicaid program, some $15 billion in Florida over the three-year period.
Florida is one of 24 states that have rejected the option provided under the Affordable Care Act, or Obamacare, to expand Medicaid with full federal funding.
Gov. Rick Scott, a staunch opponent of the Affordable Care Act, initially said in 2013 he favored expanding the program but took little or no action to press the state Legislature to do so. The Legislature, led by former House Speaker Will Weatherford of Lutz, refused to enroll during the past two sessions.
Scott said in a Tampa Tribune editorial board interview last week that he still favors Medicaid expansion. “I haven’t changed my position ... as long as the federal government is paying 100 percent,” he said.
But when asked for a response to the White House report Wednesday, Scott’s office referred questions to his campaign.
A campaign spokesman did not address the report, focusing instead on criticism from Scott’s likely Democratic opponent in the 2014 election, Charlie Crist, and praising the 2011 Florida Medicaid overhaul that moved recipients onto managed care programs.
Crist, who favors the expansion and the Affordable Care Act, called the report “yet another example of how empty Rick Scott’s jobs rhetoric is – he refused to lift a finger to create more than 63,000 new jobs in Florida by expanding healthcare to 848,000 of our fellow residents,” said an email statement from Crist campaign spokesman Brendan Gilfillan.
Medicaid, which provides health care for the poor and nursing home care for those who have spent all their assets, is normally paid for jointly by the state and federal governments, but states set eligibility standards.
The Affordable Care Act, however, gave states the option to expand their Medicaid programs to cover more people with the federal government picking up the entire tab, including all individuals in families with less than 133 percent of the federal poverty level.
That level currently is $16,105 for a single adult or $32,913 for a family of four.
Those chiefly affected by the expansion would have been younger and middle-aged adults.
Figures from the Kaiser Family Foundation suggest that Florida already is one of the stingiest states in allowing Medicaid eligibility.
It’s one of 23 states that provide no coverage for childless adults regardless of income. For a family of four, coverage for children age 6-18 is cut off above 133 percent of the poverty level, and above 140 percent for children age 1-5.
According to the report, 5.7 million people nationwide, including 848,000 in Florida, would get health coverage by 2016 if the states that haven’t expanded Medicaid under the Affordable Care Act did so.
In Florida, the expansion would result in 2.3 million additional physician visits and 201,000 individuals with a regular source for clinic care.
Some 38,000 people a year would avoid “catastrophic” medical costs, meaning more than 30 percent of household income, and 120,600 would avoid having to borrow money or skip paying bills to handle medical costs.
The additional federal spending would “increase demand for both medical and non-medical goods and services,” the report says.
“When the government purchases additional goods and services, that spurs hiring and purchases of investment goods and raw materials to produce those goods and services,” resulting in additional spending by the workers who produce them. The report used “fiscal multipliers” and studies of the effect of health care spending on the economy to calculate the impact.
That resulted in a projection of 378,700 “job years” worked in 2014-2016 if the non-participating states participated, including 63,800 in Florida.