Wednesday, January 17, 2018
Health

Key house panel says no to Medicaid expansion, sets up legislative showdown

TALLAHASSEE — Top Republicans in the Florida House split from Gov. Rick Scott on Monday and said that they will oppose a plan to expand Medicaid to 900,000 or more poor Floridians, arguing that it would increase the federal deficit, diminish health care delivery to the elderly and drastically grow an already problem-laden program.

A key legislative committee that had been studying the health care law voted along party lines to reject the proposed Medicaid expansion and the billions of dollars in federal funding it would bring. In doing so, Republicans pledged to seek other options to address Florida's 4 million uninsured.

The decision, which was criticized by Democrats, further isolates Scott among Florida's Republican elected leaders, who largely have dug in their heels against the Medicaid provision. Scott still could find an ally in the Florida Senate, which has yet to make a recommendation.

Comparing the federal government's offer to pay 100 percent of the expansion costs for the first three years and at least 90 percent after that, Rep. Matt Hudson said Florida shouldn't be swayed by a "few pieces of silver" and ignore the long-term implications of adding 900,000 people to the Medicaid rolls.

"We know that it hasn't always worked out so well when people look at short-term gain instead of long-term vision," said Hudson, a Republican from Naples.

As they pledge to seek other options, Republicans said they were particularly intrigued by the agreement struck between the federal government and Arkansas. That state received permission to use Medicaid expansion dollars to pay for people to buy insurance policies through health exchanges.

"What Arkansas did, it wasn't even a concept; I didn't even think about it," said Rep. Richard Corcoran, the Lake O'Lakes Republican who chairs the House panel.

House Speaker Will Weatherford, R-Wesley Chapel, praised the committee's decision.

"We simply cannot count on the federal government to pay 100 percent of the cost for expansion," he said. "The facts show that health care costs will go up for many Floridians, while access to and quality of health care will go down."

Democratic Minority Leader Perry Thurston of Plantation called the decision "morally reprehensible," while Rep. Dwight Dudley of St. Petersburg said it showed a "lack of vision."

Dudley said Democrats shouldn't count on Republicans to find a better way to reduce the number of uninsured.

"You didn't hear any solutions, you didn't hear any alternative ideas or plans," Dudley said of the committee's rationale. "That's pretty appalling considering they are willing to kill this, something that is a plan, something real that people can access and have."

The more moderate Senate has seemed more open to expanding Medicaid, though its committee studying the issue decided to postpone a planned discussion on the topic Monday.

Sen. Joe Negron, R-Stuart, said if the House won't back away from its opposition, then an alternative must be sought.

"If we're going to say 'no' to Medicaid expansion, let's say 'yes' to something," Negron said.

But it's too early to say what that could be, Negron said.

Last month, Scott shocked many conservatives when he endorsed a plan to expand Medicaid after fighting so hard against the law. Scott called for an initial three-year expansion, but most Republicans said it would be impossible to undo health care insurance for the Floridians who would have been covered.

It's unclear, however, how much political capital Scott is prepared to expend pushing a possible expansion. He has said it is not among his top priorities and was not included in excerpts released Monday previewing his State of the State address this morning.

Others may have to pick up the cause. On Monday, a lobbyist for the business-backed Associated Industries of Florida said Florida should not just toss aside the billions of dollars of federal money.

"What we see is that we're already paying, the business community, is already paying for the uninsured, in the most costly setting possible, in the emergency rooms," Slater Bayliss said. "We encourage you to best leverage available federal funding to ensure that we provide coverage to Floridians in a manner that protects the state's financial health."

Around the same time, U.S. Rep. Kathy Castor, D-Tampa, held a press conference at Tampa General Hospital to urge Florida legislators to expand Medicaid.

"This is the best deal going in health care today," she said.

As a safety net hospital, Tampa General faces what Castor called "daunting challenges" paying for the care of uninsured patients. In 2011, TGH paid $41 million in charity care. Safety net hospitals aren't the only ones that bear the cost of uncompensated care. Castor pointed out that insured patients pick up those costs, too, through higher premiums and co-pays.

Staff writer Jodie Tillman contributed to this report. Contact Tia Mitchell at [email protected] or (850) 224-7263.

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