TALLAHASSEE — House Republicans offered a bare-bones alternative to expanding Medicaid on Thursday, bypassing more than $50 billion in federal aid while setting up a clash with Gov. Rick Scott and the more moderate Senate.
The House's plan would cover up to 130,000 disabled adults and adults with children, far less than the estimated 1 million Floridians who could be covered by federal money.
The plan would offer enrollees $2,000 a year in state assistance to help them purchase insurance on a state-run health exchange. It would cost the state as much as $266 million annually.
In a statement Thursday, Scott all but rejected the approach.
"The House's plan will cost Florida taxpayers on top of what they are already taxed under the president's new health care law," Scott said. "This would be a double-hit to state taxpayers."
The Senate, meanwhile, is considering an alternative that would use the federal money to subsidize private health care coverage. Neither chamber is considering expanding Medicaid as the federal government initially anticipated.
The proposal from the House is the latest in a series of twists as Republicans debate how to expand health care in the state.
Scott stunned conservatives in February when he announced he would support expanding the state's Medicaid rolls, arguing that the financial terms were too good to pass up.
But Republicans in the House and Senate disagreed, arguing that the Medicaid system was too flawed and that the federal government couldn't afford the additional costs.
Both now have alternatives. Sen. Joe Negron, R-Stuart, wants to accept the federal money but use it for private health care coverage, not Medicaid. A proposal by Sen. Aaron Bean, R-Fernandina Beach, is similar to the House plan and does not include federal money.
The House plan, drafted by Rep. Richard Corcoran, R-Land O'Lakes, would provide $2,000 a year for people to help purchase preventative and primary care coverage.
The program would cost the state $14 million initially but would grow to $266 million as people enroll. Overall, the state expects to spend $2 billion over 10 years to cover 130,000 people.
By comparison, expanding Medicaid would cost the state about $3 billion over 10 years to cover an additional 1 million people, according to estimates.
House Speaker Will Weatherford, R-Wesley Chapel, says the state cannot rely on federal assistance.
"I think the most important part is that we do not rely upon federal dollars that we can't count on," Weatherford said. "We said that we thought our plan needs to be sustainable. We think that our plan is sustainable with the utilization of state funds, and it has real components of personal responsibility and accountability embedded into it."
Both the House and Bean's plans expand the mission of Florida Health Choices, a state-run insurance exchange that predates the federal health care law and was the brainchild of then-House speaker, now U.S. Sen. Marco Rubio. The proposals are also similar to former Gov. Charlie Crist's failed Cover Florida initiative, which asked insurance companies to offer health plans at discount prices.
Negron, the Senate's budget chief, said he had time to review Corcoran's plan and called it comprehensive. He noted that while it expanded coverage, his own plan would cover 1 million people.
"It gets 130,000 Israelites across the River of Jordan," Negron said. "I'd rather have 130,000 than zero. So 130,000 is a good start."
Democrats, meanwhile, accused Republicans of cutting back on a planned raise for state workers to help pay for the House plan. House leaders amended the budget Thursday, stripping $400 from a proposed $1,400 across-the-board pay raise for state workers.
"Monies are taken from state workers for this eenie beanie plan for Medicaid expansion," said House Minority Leader Perry Thurston, D-Plantation.
House Appropriations Chairman Seth McKeel, R-Lakeland, filed the lower pay raise proposal on Tuesday — after House Republicans had blocked time for a Monday meeting to discuss their health care proposal.
Asked several times on Thursday if this change was made to free up money, McKeel responded with the vague answer that the change was made to save millions for "further policy initiatives."
Times/Herald staff writer Michael Van Sickler contributed to this report.