House Poised to Approve "Free Market" Medicaid Expansion Alternative

Apr 19, 2013

Under the federal health law states have the option to expand their Medicaid programs to include more low-income people. A million more Floridians are eligible for Medicaid under the law. The legislature rejected the expansion in favor of state-based solutions. Earlier in the week a Senate panel endorsed two alternative proposals to the expansion and Friday it was the House’s turn.

The House plan carried by Republican Representative Travis Cummings would spend $240 million a year to support  116,000 adults with children and people with disabilities living below the federal poverty level. But opponents to the House plan, say even with two-thousand dollar stipends to purchase private health insurance, many people won’t be able to afford the House proposal:

“Our analysis and belief is that virtually no one will be able to benefit from that program primarily because of the requirement that you have premium payments," said Karen Woodall, a lobbyist and Executive Director of the Florida Center for Fiscal and Economic Policy.

The House plan calls for people to contribute $25 a month to their healthcare costs. Woodall people below the federal poverty level, under $12,000 for a single person, can’t afford even that.

House Republican’s are adamant that the state cannot afford to accept the federal government’s $51 billion. Representative Eric Fresen (R-Miami) says Medicaid already takes up the bulk of state budget dollars. Even if Florida were to expand the program and accept federal money, it would still have to spend $3.5 billion of its own after the federal government’s share of the expansion costs fall  to 90 percent after three years.

“The only thing we can fully know, is that the 10-percent...will strain our legislative budgets in the years moving forward," Fresen said. "And I can’t vote for something that the only certainty I have is that if we repeat and expand that which is eating away at our budget today, is going to continue to increase that proportion of our state budget.”  

Democrats have pushed for the traditional Medicaid expansion.  They voted against the House bill, and were chided for it by Republicans like Republican Representative Richard Corcoran, who crafted the plan.

“If we never had ObamaCare, and we never had Medicaid expansion, and a Republican-led legislature put forth a plan that covered 527,000  lives of people under 138-percent of poverty...if we were on the floor, the board would be 120-to-nothing.”    

Meanwhile  a bill in the Senate accepts the federal money and steers the million people who would have qualified for Medicaid into private health plans.  Lawmakers have two weeks to reach a deal. Earlier in the week Senator Joe Negron outlined a path toward a compromise that would allow people to choose whether to accept a state stipend to shop for their own health insurance, or use the system outlined in the Senate.