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House Medicaid Alternative Plan Gets A Skeptical Reception

Florida House of Representatives

Reactions to a house plan expanding health insurance coverage to an additional 115,000 uninsured Floridians is getting the cold shoulder from Governor Rick Scott and healthcare groups. The measure is the House's response to the federal Medicaid expansion, which lawmakers rejected last month.

The House plan by Republican Representative Richard Corcoran, would give recipients $2,000 a year to purchase private health insurance on the state's Florida Health Choices marketplace for small businesses. They would be required to pay $25 a month premiums. The program would cost the state $237 million a year.

"It's not an alternative. It's a cruel joke. It’s not even close to what we have....without accepting $51 billion from the federal government, they're just slapping a new name on the Cover Florida...from the few years ago," said Democratic Senator Darren Soto during the chamber's Democratic Caucus meeting Thursday.

The House plan doesn't rely on the $51 billion in federal Medicaid money the state would have received over the next decade in exchange for expanding access to Medicaid for an additional million low-income Floridians, those under 138 percent of the federal poverty level.

The House proposal also covers far fewer than a plan by Republican Senator Aaron Bean, which would have used Florida Health Choices to serve some 600,000 Floridians under 100 percent of the federal poverty level. The Bean plan, or BeanCare, would also not have used federal Medicaid funds.

Instead, the House plans to fund its proposal by cutting planned state employee pay raises from $1,400 to $1,000.

The proposal favored by the Senate is one by Senator Joe Negron, which would allow roughly the same number of people eligible for Medicaid under the federal health law, to purchase private plans on the state's "Healthy Kids" program. Those purchases would be funded by pulling down the federal Medicaid money, and that's the proposal that Governor Rick Scott says he prefers.

"As it stands today, the Senate’s plan is in line with what I said I would support because it protects both state taxpayers and the uninsured in our state. I look forward to continuing to work with both the House and the Senate as they discuss ways we can improve our healthcare system,” Scott said in a statement.

The Governor also blasted the House plan.

"The House’s plan will cost Florida taxpayers on top of what they are already taxed under the President’s new healthcare law. This would be a double-hit to state taxpayers. The Senate’s plan will provide healthcare services to thousands of uninsured Floridians while the program is 100 percent federally funded".

Groups like the Florida Hospital Association and the healthcare advocacy organization Florida CHAIN, say they're disappointed in the House proposal as well.

But the fact that the House put something on the table was enough to appease House Democrats, who said they'd oppose the budget unless their Republican counterparts unveiled a plan.

“Today, House Republican leaders have unveiled a bare-bones health coverage plan for uninsured, low-income Floridians that’s deserving of public consideration and review,” House Minority Leader Perry Thurston said in a statement.

“Though personally, at first glance, I am not enthralled by the proposal, I recognize that it is at least a minimal attempt toward achieving a legislative compromise on the important topic of health coverage for Floridians.”

Details of the House plan were first told the Miami Herald and Tampa Bay Times. Earlier in the day, House Speaker Weatherford and Rep. Corcoran held a conference call with a select few reporters. They later followed up with a prepared statement on the plan.

“The Florida House has developed a plan that will fit the needs of Florida, not the requirements of Washington,” said Speaker Weatherford (R-Wesley Chapel).  “Our plan increases our commitment to a strong safety net and ensures Floridians are not on the hook for billions that we currently do not have.”

The proposals sponsor, Rep. Corcoran, hailed it as a “free market” approach that “rejects the federal government’s ‘all or nothing’ plan”.

“By utilizing the forces of the free market, we are providing low-income Floridians with quality options that are sustainable and will not be funded by additional federal dollars,” he said, “This plan provides meaningful health care options to those who need it most without risking Florida’s financial future.”

The House committee on the Affordable Care Act will meet Monday to review Corcoran’s plan. Observers say they’re optimistic the House and Senate will come to an agreement on how many people to insure and whether to accept federal funds to do it.

Correction: An earlier version of this story incorrectly said the original Medicaid expansion would have covered one billion people...that "b" should have been an "m", as in "one million" people.

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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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