House Blasts, Then Kills, Medicaid Expansion

Jun 8, 2015

Medicaid expansion, the issue that caused this week’s special session, has flat lined. Now that the House and Senate have agreed to disagree, it’s up to the U.S. Supreme Court to decide whether 1.8 million Floridians go without health insurance.

A Senate Republican plan that would have enacted a business-friendly Medicaid expansion program failed in the House after a seven-hour debate.

Supporters of Medicaid expansion had twin goals – lower the state’s uninsured population and collect $1 billion federal health care dollars.

But Senate Republicans couldn’t get past a buzz saw of conservative opposition to federal entitlement programs. Here’s how health care chairman Jason Brodeur, a Sanford Republican, describes it.

“I think what you’re finding on this side of the Capitol, and particularly the Republican Party in general, is the disagreement with the premise that we need more government programming on top of what we already have.”

And here’s how Representative Paul Renner, a Palm Coast Republican, describes it.

“The taxpayers in the state of Florida will have a hook in their mouth for years to come. And it’s simply unaffordable. Medicaid, currently, the existing population, is growing so fast, it’s crowding out all of the other priorities. Priorities that we care about, public safety, education, infrastructure.”

And here’s how John Wood, a Winter Haven Republican, describes it.

“I may be just a simple country lawyer, but I know an entitlement when I see one and FHIX is simply Obamacare Medicaid expansion with a clever name. An entitlement program is defined as a government program providing benefits to members of a specific group and FHIX fits all of the criteria.”

Opponents raised the specter of fraud and abuse. They also warned that Medicaid expansion would leave Florida in the lurch when the torrent of federal dollars trickles below the 90 percent match rate.

During an intense debate on the House floor, Democratic supporters tried to put a human face on the issue. Representative Amanda Murphy of New Port Richey reminded her colleagues the plan was a compromise written by Senate Republicans. Then she quoted the Book of Matthew, Chapter 25, verse 37.

“’Assuredly, as much as you did not to the least of these, you did not to me. And these will go away to everlasting punishment, but the righteous into eternal life.’ Members, before us today, we have a plan that is the proverbial olive branch.”

But what’s not clear is what happens next in a state that already has the highest participation rate in Obamacare.

.The U.S. Supreme Court is about to decide whether consumers can continue getting federal help with insurance payments in states like Florida, where lawmakers refused to set up exchange networks.

If the Justices say the money should stop flowing, that could leave 1.8 million Floridians without health insurance, says Georgetown University health policy researcher Joan Akerman.

“Opposition to accepting the federal dollars really comes from an ideological place. There’s really no economic justification for it, and for Florida, which ranks 49th in the country with respect to the number of uninsured adults, you really have a serious problem on your hands.”

Brodeur, the House health care chairman, says the urgency of the problem will depend on how soon the Supreme Court says the money should stop.

Senate Republican Chief Tom Lee of Brandon says there is no backup plan, at least not yet.

“Well, we’ve got our hands full here, and we’re trying to work through, our primary concern is getting a budget done.”

Lawmakers expect to debate a bill dealing with state worker health insurance plans. But Brodeur bristled when he was asked whether the bill would change the highly discounted health plans that lawmakers enjoy.

“So the purposes of the bill is to make fundamental change in how it is people think about health care and consumerism.”

With the big health care issue behind them, lawmakers are expected next to complete budget negotiations.