Tampa chamber: Businesses concerned by Legislature's inaction on Medicaid expansion
For Tallahassee, refusing additional federal funds to expand Medicaid may turn out to have been the easy part.
It will take longer, a half-dozen Hillsborough legislators acknowledged Tuesday, to come up with an alternative to provide health care coverage to an estimated 1 million uninsured Floridians.
The business impact of legislative decisions on health care was a main issue when about 120 members of the Greater Tampa Chamber of Commerce sat down for lunch with seven Hillsborough County legislators at the Embassy Suites Hotel in downtown Tampa.
After an easy opening question, chamber chairman Gregory Celestan told the lawmakers to prepare for a hardball.
Some Tampa businesses, he said, are “very concerned about significant additional health insurance costs” because of the Legislature’s “refusal to expand Medicaid.”
“We will be at a competitive disadvantage when recruiting new businesses or adding jobs,” Celestan added. “How would you respond?”
Before we get to the responses, here's some background: Under President Barack Obama's Affordable Care Act, the federal government has offered $51 billion to provide insurance coverage to 1 million low-income Floridians through an expansion of the Medicaid program. But state House Republicans blocked that from happening during the Legislature's session that ended earlier this month.
Now, without a Medicaid expansion, business owners across Florida face either providing health insurance for their employees or paying federal penalties.
That’s because the federal law requires businesses with more than 50 full-time employees to provide health insurance coverage to anyone working more than 30 hours a week.
In industries like agriculture, tourism and hospitality, many workers would have been eligible for an expanded Medicaid program.
But with no Medicaid expansion, those workers must either get health insurance from their employers or buy coverage on a federal insurance exchange. An estimated 400,000 Floridians who would have qualified for Medicaid expansion are eligible to purchase insurance on the exchange.
And if workers use the federal exchange, their employers will be penalized — $2,000 per full-time employee (not including the first 30). Total additional costs to businesses statewide have been estimated at nearly $146 million per year.
On Tuesday, legislators’ responses to Celestan’s question varied. But they generally acknowledged they’ve got work to do and could use insight and suggestions from stakeholders in the private sector.
“This issue’s not going to go away,” said state Sen. John Legg, R-Trinity. the lone senator on the chamber’s panel.
Legg said he didn’t know if Gov. Rick Scott is going to call a special session on the issue, though he doesn’t expect one anytime soon.
“But I do expect us to be wrestling with this issue for the next session or two until we come up with a solution,” he said, “because there’s too many uninsured and, secondly, the businesses are going to be paying for it.”
Noting “it's the law,” state Rep. Betty Reed, the sole Democrat on Tuesday’s panel, said the state should go ahead and expand Medicaid.
“I believe we should have health care people can use,” she said.
State Rep. James Grant said he thinks “everybody agrees that there are people who truly need this care and that we ought to look at being innovative.” But he wants a solution that embraces the private sector rather than the federal government.
“I do think it will require stakeholders coming to the table and saying, ‘You know what? We think we can do things differently and that we can be a model for other states,’ ” said Grant, R-Tampa.
Meanwhile, Rep. Dana Young, R-Tampa, said the state will benefit from letting the federal government set up an initial insurance exchange instead of doing the job itself.
Florida will be able to watch other states that are creating their own exchanges, she said, and could choose to do so in the future.
“We’re going to see what different states are doing, and then we will have the benefit of seeing what worked for people,” she said. “We’re basically going to free ride to an extent off of other people’s work, and that’s going to save the state some money.”