Make us your home page
Instagram

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

As focus shifts to new health care issues, Florida Democrats say Medicaid expansion still a priority

TALLAHASSEE — Florida's 2013 legislative session practically started and ended with Medicaid expansion at the center of debate, with House Republicans blocking a plan to use federal dollars to reduce the number of uninsured Floridians.

This year, House Republicans pledge to tackle issues that have long lingered on the back burner, such as providing more independence for highly trained nurses, increasing the number of medical students who go into primary care and regulating virtual doctor visits.

But even as the focus shifts from Medicaid expansion, Democrats say it remains a top priority.

"I don't think they'll have it in their agenda, but it's on our agenda," said House Minority Leader Perry Thurston, D-Fort Lauderdale. "So we will be talking about it. And if they want to pretend it's a big elephant in the room that's not really there, then it's up to them."

Sen. Joe Negron, a Stuart Republican, disagrees. He crafted the plan that House Republicans rejected to use $51 billion in federal funding to purchase private insurance for poor Floridians. The House and the Senate had the same goals but after "spirited, full and fair debate" were unable to reach an agreement, Negron said.

"I don't know how productive it would be to simply film the same movie over again," he said. " … I think the fact there are so many other health care issues is an indication that the Legislature has moved on to other issues where we can make progress."

Proponents of Medicaid expansion are working behind the scenes to come up with an alternative that House Republicans will allow, but it's a steep, uphill battle. Meanwhile, all sides agree these other topics deserve attention.

House Speaker Will Weatherford created a special committee to gauge health care workforce needs and recommend changes in Florida law. The committee has focused most on Florida regulations for advanced practice nurses, the most restrictive in the nation.

"Florida is really behind the curve on addressing the workforce issues; many other states throughout the nation have made some of the changes that were suggested here today with tremendous success for many years," Rep. Jose Oliva, R-Miami Lakes, said Friday after a committee meeting.

Nurses with post-graduate training want to prescribe controlled substances, sign death certificates and practice independently from medical doctors. The Florida Medical Association, a powerful advocacy organization for doctors, has fought against proposals to give these professionals more duties outside of a physician's supervision.

Telemedicine — the emerging practice of using technology and the Internet to facilitate virtual doctor-patient visits — is also a field where other states have outpaced Florida. Some Florida hospitals and doctors, especially in rural areas and certain specialties, are using telemedicine for evaluations and checkups.

Right now, a state Board of Medicine rule requires face-to-face meetings in order for a doctor visit to be reimbursed except in some instances where drugs are being prescribed.

Proposals in the House and the Senate would require insurers to pay for services regardless of whether they are provided in-person or via services like Skype. Lawmakers will also discuss whether telemedicine should be reimbursed at the same rate as face-to-face visits.

And, of course, there are the perennial requests for more health care spending.

The state increased funding for medical residency slots to $80 million last year, but hospitals say more is needed. The Florida Medical Association is also lobbying for a loan forgiveness program to encourage new doctors to go into primary care instead of more lucrative specialities.

"We come out of school with an incredible amount of debt, and it would be easy to be a radiologist and get that debt paid off faster but we really want to be family doctors," said Dr. Bob Raspa, the Jacksonville-based board chairman of the Florida Academy of Family Physicians.

Even with all of these new topics, many old ones will still need attention, such as Medicaid funding for hospitals and ongoing implementation of the Affordable Care Act.

For example, the federal government provided 100 percent of the funding for states to boost reimbursement rates for Medicaid doctors through the end of 2014.

If states want to keep those higher rates in 2015 and beyond, they will have to shoulder at least some of the cost. The Florida Medical Association estimates Florida's share to be $150 million a year, money that would have to be reflected in the 2014-15 budget crafted during the 2014 session.

The president of the South Florida Hospital and Healthcare Association believes that all of those topics are worthy of discussion, but not at the expense of Medicaid expansion.

"We haven't given up on it," said Linda Quick.

Health care groups have started engaging the business community to make the economic case for reducing the number of uninsured Floridians. Florida is not only rejecting billions of federal dollars, they argue, but is also allowing businesses with low-wage, full-time workers to shoulder the health insurance costs while stifling the creation of tens of thousands of jobs the federal funding would have created.

Nothing is more important than providing health care for the 764,000 Floridians who make too much to qualify for Medicaid under current standards but not enough to qualify for subsidies to buy insurance on the federal health exchange, Quick said.

The nurse practitioner and telemedicine conversations are worth having, she said, but amount to small peanuts in the grand scheme of things.

"I don't see them as controversial or hotly contested," she said, "so I would like to think that (legislators) could come to some consensus on those issues relatively early in session and then do the work that will be required to craft an expansion option that everyone could agree to."

Contact Tia Mitchell at (850) 224-7263 or [email protected]

As focus shifts to new health care issues, Florida Democrats say Medicaid expansion still a priority 01/12/14 [Last modified: Sunday, January 12, 2014 10:18pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times

    

Join the discussion: Click to view comments, add yours

Loading...
  1. Late fumble, field goal send Florida State to another loss

    College

    TALLAHASSEE — Florida State's streak of 35 consecutive bowl appearances is in serious jeopardy after a last-second 31-28 home loss to Louisville on Saturday.

    Louisville's Lamar Jackson gets past Florida State's Matthew Thomas to score in the first quarter of an NCAA college football game, Saturday, Oct. 21, 2017, in Tallahassee Fla. (AP Photo/Steve Cannon) FLSC102
  2. Funeral starts for soldier at center of Trump fight

    Military

    COOPER CITY, Fla. (AP) — Mourners remembered not only a U.S. soldier whose combat death in Africa led to a political fight between President Donald Trump and a Florida congresswoman but his three comrades who died with him.

    The casket of Sgt. La David T. Johnson of Miami Gardens, who was killed in an ambush in Niger. is wheeled out after a viewing at the Christ The Rock Church, Friday, Oct. 20, 2017  in Cooper City, Fla. (Pedro Portal/Miami Herald via AP) FLMIH102
  3. Seasoned cast scores an extra-base hit for St. Petersburg Opera with 'Faust'

    Stage

    TAMPA — Charles Gounod's Faust sets the table early. The world-weary philosopher immortalized in a dramatic poem by Johann Wolfgang von Goethe is in his study, lamenting his state of affairs. He's willing to give away everything he has to be young again, even his soul.

    The St. Petersburg Opera Company begins its season with Faust, in a production seemingly aligned with the original intent of French composer Charles Gounod and librettists Jules Barbier and Michel Carre. [St. Petersburg Opera Company]
  4. Police plan community meeting as search for Seminole Heights killer continues

    Crime

    TAMPA — With people in Seminole Heights on edge following three related shooting deaths on their streets, police have planned a community meeting for Monday.

    The three Seminole Heights victims, from left: Benjamin Edward Mitchell, 22; Monica Caridad Hoffa, 32; and Anthony Naiboa, 20. [Facebook, family photos]
  5. Bucs-Bills: Tampa Bay's fatal habit of falling behind

    Bucs

    TAMPA — Okay, all you road scholars, why do the Bucs keep falling behind in games not played at Raymond James Stadium?

    Arizona Cardinals quarterback Carson Palmer (3) recovers a fumble during the first half of an NFL game between the Tampa Bay Buccaneers and Arizona Cardinals at University of Phoenix Stadium in Glendale, Ariz., on Sunday, Oct. 15, 2017.