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House Dems Use Budget As Bargaining Chip For Medicaid Expansion

House Democrats have pushed all session for their Republican counterparts to extend health insurance coverage to more Floridians. Ideally, that would have happened, had lawmakers chose to expand the state’s Medicaid program for low-income Floridians under the federal health law. Now the House Democrats say they’ll vote against the state budget, if legislative leaders don’t offer up an alternative to the Medicaid expansion.

“We think that healthcare coverage for working Floridians is so important that we’ve decided to take a caucus position against the budget," said Minority Leader Perry Thurston.

Thurston says he wants to see an alternative plan which would cover a similar group of people and tap into federal Medicaid money. Would he settle for something that covers fewer people—like a proposal in the Senate that rejects federal funding and only covers about 600,00 people?

“The session is young. We’re certainly open to any suggestions," he said.

House Republican leaders have expressed interest in a plan like one pitched by Senator Aaron Bean that would use state funds to support premium assistance for low-income people who make less than $11,500 a year, or 100 percent of the federal poverty level.  That plan does not draw down federal Medicaid money. But Democratic Representative Mia Jones says it would be foolish of Florida to leave more than $50 billion  of federal Medicaid money on the table.

 “We’ve been a donor state and known as a donor state for many years. We don’t want to be at the top of that donor list while at the same time were not making sure we’re providing the coverage available for over a million Floridians," she said.

House Dems decision to vote against the budget is the latest round of volleying on the question of whether to extend health insurance to more low-income Floridians.

Under the federal health law, state’s that extended coverage to people up to 138 percent of the federal poverty level (around $22,000 a year for a family of three) would receive 100 percent funding for the extra people for the first three years. That support would fall to 90 percent in the out years. State economists say the expansion would cost Florida about $4 billion. In return, the federal government would send down more than $50 billion dollars over the next decade. But House Democrats may soon get what they want. House Republicans are working on a proposal.

“The focus internally is what the alternative should look like and what groups should we be focusing on. The people we believe who are in a vulnerable position and need to have access to care. We’re weighing all those options and communicating with them as well," said House Speaker Will Weatherford.

The plan favored in the Senate is one by Senator Joe Negron. It covers roughly the same number of people as the federal Medicaid expansion, but uses a state program for those people to get private insurance plans. Negron’s plan may also make the state eligible for the federal Medicaid money. 

 “We obviously see where the Senate is going. I think that accepting 6 to 7 billions of dollars to put a million people on a plan is unsustainable. What we’re interested in in the Florida House is a sustainable plan. One that addresses the true safety-net needs of the state of Florida, and at the same time is sustainable by the state," Weatherford said.

Earlier in the session Speaker Weatherford adamantly opposed accepting any federal dollars. The House’s Affordable Care Act Committee is scheduled to meet early next week but a plan could be revealed before then. Representative Richard Corcoran is expected to lead the House's efforts. Observers say they expect the chambers to reach some sort of compromise, and Governor Rick Scott says he’s still optimistic the legislature will come up with something. 

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Lynn Hatter is a Florida A&M University graduate with a bachelor’s degree in journalism. Lynn has served as reporter/producer for WFSU since 2007 with education and health care issues as her key coverage areas.  She is an award-winning member of the Capital Press Corps and has participated in the NPR Kaiser Health News Reporting Partnership and NPR Education Initiative. 

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