FMA Support Of Medicaid Expansion May Not Be Enough To Change Lawmakers' Minds

Jul 29, 2014

Florida Medical Association
Credit flmedical.org / Florida Medical Association

For the past two years, Florida’s top state lawmakers have opposed expanding the Medicaid program for low-income people under the federal health law. The state has rejected more than $51 billion under the federal Affordable Care Act to increase income eligibility limits and add more people to the rolls. Now one of the state’s most powerful physician groups, the Florida Medical Association is backing a Medicaid Expansion, but it may not be enough to change state lawmakers' anti-ACA stance.

Families USA, a national healthcare advocacy group, has been highlighting Florida’s refusal to expand Medicaid under the federal health law. Tuesday, it took aim at Florida again, this time, by releasing a profile on the 1.1 million Floridians who could benefit from the expansion, should the legislature choose to go through with it.

"We’re talking about waiters and waitresses, hotel support staff, construction workers and cashiers. They include people who take care of our family members, childcare workers and home health aids," said Dee Mahan, Families USA’s Medicaid Director during a Tuesday conference call with reporters.

Families USA and the state healthcare advocacy group Florida Chain partnered on the study. It shows 51 percent of Floridians who would qualify for Medicaid under the federal health law’s higher income levels, are working adults.  Right now, most of Florida’s Medicaid consumers are low-income pregnant women, children and the disabled. The program largely excludes low-income single adults,  but if it were to expand, they’d be covered too.  

Healthcare groups including hospitals, nursing homes and nursing organizations have urged the state legislature to expand Medicaid, but one group, the Florida Medical Association—has been largely silent on the issue for the past two years. Until now.

“We’ll be one of the groups lending our voice to the support of expansion and it will be up to the legislature to do what they’re going to do," says FMA General Counsel Jeff Scott.

He says the group is now backing a Medicaid Expansion, but on one condition— it has to include higher reimbursement rates to all doctors—not just primary care physicians as the ACA called for. The FMA is a powerful lobbying force in the legislature, but University of South Florida political scientist Susan McManus says the organization is not what it used to be, and the group’s decision to support expanding Medicaid may not be enough to change the Republican-led legislature’s anti-expansion stance.

“Increasingly the physician community is more divided on this issue and other issues than they were in years past. So I don’t think in and of itself, the FMA’s endorsement of the Medicaid Expansion is what it once was," she says.

Republican state legislative leaders in the House have opposed the Medicaid expansion over concerns it will cost Florida taxpayers too much money. They’re also opposed to the overall Affordable Care Act. Florida currently spends more than $20 billion on Medicaid, although most of that figure is made up of federal support. This year, state lawmakers largely ignored the Medicaid expansion question--hesitant to rock the waters during an election year. But McManus says, it could be more of the same in Florida, as the Affordable Care Act enters its third year.

“Next year won’t be a contentious election year. But the bottom line is, one endorsement of one group, even as powerful as the FMA is, isn’t enough, in itself, to pull an issue across the finish line.”

Florida is now in the minority of state’s that has turned down federal funds to expand Medicaid. And McManus says state officials could be waiting to see how the program plays out in those states—especially those led by fellow Republicans—before deciding when and if they will get involved.