House Says "No" To Medicaid Expansion

Mar 4, 2013

The House Affordable Care Act Committee says Florida can’t afford to expand Medicaid to some one million additional low-income Floridians.  Republican Representative Kathleen Passidomo says there’s no guarantee the federal government will maintain the high level of support for the expansion it’s promising:

“What the federal government gives it can take away, then we are going to have enormous costs that we’re going to have to shoulder, she said. 

In speaking against the expansion, House Committee Chairman Richard Corcoran likened it to the state’s $20 billion class size amendment, and says Floridians can’t afford that same kind of growth in Medicaid.

“We have a situation where you have tons of people saying, ‘its good, it’s good, let’s do it.’ And then ten years down the road...these are dollars that compete with education dollars, these are dollars that compete with every other dollar in the budget ten years from now when the estimates are way off.”

Opponents worry Medicaid would crowd out other critical funding areas. But the Senate seems to be heading in a different direction.

“I think there’s a very legitimate issue on how to do it. And that’s what we’re wrestling with. But I don’t buy this idea that we don’t have the capacity and ability to provide healthcare to people in our state who need it," said Committee Chairman Joe Negron.

The senate has postponed its decision. The move comes two weeks after Governor Rick Scott said he’d support an expansion of Medicaid.

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Update 1:52 pm:  The Florida Democratic Party released the following statement in response to the House select committee’s rejection of Medicaid expansion. From Executive Director Scott Arceneaux:

“Today, in a display of Gov. Rick Scott's complete failure to lead his own party, House Republicans voted against expanding Medicaid to nearly a million Floridians. Despite broad public support the House GOP put politics before the well-being of Floridians. This partisan foot-dragging at the expense of Florida’s most vulnerable is as egregious as it is wrong. Floridians have spoken and the cost of doing nothing is too high.”

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Update 1:15 pm: Reactions to the House PPACA Committee are rolling in. From House Speaker Will Weatherford:

“I am proud of the thoughtful, thorough and deliberative approach that our Select Committee took on the important issues related to Medicaid expansion and health exchanges.  I received their recommendations and agree that expanding Medicaid and setting up a state exchange is not in the best interest of our state. We simply cannot count on the federal government to pay 100 percent of the cost for expansion. The facts show that healthcare costs will go up for many Floridians, while access to and quality of healthcare will go down. The 'all or nothing' approach that the Obama administration is offering will not work for our state. I know there will be continued discussion about this matter, and I look forward to exploring better policies for our state.”

From the James Madison Institute:

"The House made the right decision today to not draft a committee bill expanding Medicaid under PPACA provisions. Many Members expressed valid concerns that this could hurt the people that it is aimed at helping. State leaders should focus on providing more access to quality care -- expanding a program that is inefficient in this effort is not a way to do that. Additionally, in our recent poll of 600 registered Florida voters more than 63 percent said they are wary that the federal government would keep the funding level promises made, and clearly many House Members share this worry. If history is any indicator, costs of such programs are often underestimated and there has been examples of the federal government going back on their promise before. These issues cannot be ignored."

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The House has signaled it won’t go along with an expanding Medicaid coverage to more than a million low-income Floridians under the Affordable Care Act. The vote came shortly after a joint committee hearing on the financial impact the law would have on the state.

Under the federal healthcare law, the state has the option to expand its Medicaid program to more people, with the federal government picking up the tab for all of the additional people in the first few years. That support would fall to 90 percent in later years.

Governor Rick Scott had signaled two weeks ago that he would support an expansion of Medicaid after the federal government approved the state’s plan to privatize the system. But in a meeting today, the House’s Select Committee on the Patient Protection and Affordable Care Act (PPACA) said the state can’t rely on promises from the federal government that it may not be able to keep.

“What the federal government gives, it can take away,” said Representative Kathleen Passidomo, R-Naples.

The vote against the Medicaid expansion was based on party lines, with Republicans voting no and democrats, the minority party, voting in favor of the expansion.

“We’re at the bottom of the barrel for people who need these services,” said Minority Leader Perry Thurston, who supported the Expansion.

Earlier in the day, state economist Amy Baker told a joint meeting of the House and Senate PPACA committees that the state could see gains in employment, wages and state revenues. But Baker also presented worst-case scenarios that projected decreases in personal incomes, and lower state revenues.

Meanwhile, the Senate has postponed a meeting originally set for later today.

“The Medicaid issue is critically important and whether Senators support or oppose expansion, the choice comes with far reaching consequences for individuals, health care providers, and the entire state,” said Joe Negron, Chair of the Senate's PPACA committee, in a statement.

“The additional time between today and our next meeting will allow Senators to review and study these important issues to ensure that our final decisions and recommendations receive the thoughtful and careful consideration they deserve.”

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