House And Governor Dig In On Medicaid Expansion While Senate Stays Mum

Mar 5, 2013

The legislature has kicked off its annual lawmaking session and Medicaid is shaping up to be a big battle. Florida would see billions of dollars flow into the state over the next three years if it extends Medicaid coverage to about a million low-income people under the federal health law. But with the House standing opposed, the Governor in favor and the Senate still debating—the legislature starts session at an impasse.

“I’m opposed to Medicaid expansion because I believe it crosses the line of the proper role of government. I believe it forces Florida to expand a broken system that we’ve been battling Washington to fix. And I believe it will ultimately drive up the cost of healthcare in Florida," said House Speaker Will Weatherford Tuesday in opening remarks to the chamber.

Weatherford’s comments came a day after a House panel recommended the state not expand Medicaid under the Affordable Care Act. The House, which has traditionally been the more conservative chamber, balked at the price tag: estimates are in the billions of dollars over the next decade. don’t trust the federal government to uphold its end of the deal.

“What the federal government gives it can take away," said Republican Representative Kathleen Passidomo.

Under the healthcare law, the federal government would foot 100 percent of the extra costs for the first three years. That support would drop to 90 percent in the out years. Governor Rick Scott has said he’d support an initial three year expansion. And in his State of the State Address Tuesday, Scott reinforced his stance.

“I cannot, in good conscience, provide the uninsured access to care," Scott said to cheers from Democrats, and mostly silence from Republicans.

The Governor, who was once a staunch opponent of the federal health law, has been accused of flip-flopping. Conservatives have blasted him for supporting the expansion.

Meanwhile, the Senate is still weighing its decision. Republican Senator Joe Negron, who crafted Florida’s statewide Medicaid Managed Care System, says he doesn’t believe in an out-and-out rejection of the Medicaid expansion without any way to provide support to the nearly four million Floridians without health insurance now.

“The concerns about Medicaid expansion are very real and very legitimate. But I don’t find persuasive the idea that we just can’t. We just have to have people go to the Emergency Room when their 11-year-old kid has an ear ache at 2 am. That that’s the best we can do. We can do better than that.”  

If the Senate says yes to Medicaid, it would create a three-way stand-off among the House, Senate and Governor. And  says the situation is complicated at this point:

“I think this is a pretty important bargaining chip. So this would have to be pretty high level. I think if the Senate comes out on the opposite side here, you’re going to see back room negotiations and ideas and issues trying to persuade the other House to come over to the position," said Florida State University Political Scientist Carol Weissert.

When the U.S. Supreme Court upheld the Affordable Care Act, it also ruled states have the option to expand Medicaid. Governor Rick Scott became the seventh Republican Governor to announce his support of the expansion. Opponents say expanding Medicaid doesn’t guarantee better health outcomes or access to doctors—and observers say that’s true. But if Florida chooses to reject the Medicaid money, it would be footing the bill for other states, and low-income Floridians would still be left uninsured.