Monday, September 17, 2018
Health

Senate Republicans pitch Medicaid expansion alternative

TALLAHASSEE — Top Senate Republicans, who last week said no to expanding Medicaid, want to instead use the $55 billion offered as part of President Barack Obama's health care law to funnel poor Floridians into subsidized, private health insurance.

The plan, crafted by Sen. Joe Negron, R-Stuart, would expand the state's Florida Healthy Kids program to cover qualifying adults 18 and older. People in the expanded plan would be required to pay small premiums and co-pays, and they would have access to health reimbursement accounts to help cover out-of-pocket expenses.

The program, which gets its first hearing today, would have to win the approval of both a skeptical House and the federal government. And there will be plenty of questions, including how many people would be covered, and how much the program would cost the state.

Negron's proposal represents a middle ground for Republican senators, many of whom are uncomfortable adding as many as 1 million Floridians to the state's Medicaid rolls but equally leery of turning down $55 billion in federal aid over the next decade. A Quinnipiac University poll released Wednesday found that 50 percent of Floridians say the state should expand its Medicaid program, while 40 percent said it should not.

Gov. Rick Scott, who last month broke from conservatives and endorsed a plan to expand Medicaid, told the Times/Herald he's open to this compromise.

"My understanding is it's consistent with what I said I would support," Scott said. "It's 100 percent federal funding. It's taking care of the uninsured. It's using the two Medicaid waivers that I was able to get that will give us more flexibility. And it's going to deal with cost, quality and access to care."

It will also have a new name: Healthy Florida.

The program builds on Florida Healthy Kids, which serves children whose parents are without insurance but make too much money to qualify for Medicaid. Parents now pay $15 or $20 a month for private health policies for their children, plus co-pays of $5 or $10, depending on the type of services received. Florida Healthy Kids currently has 236,000 members.

The new program would be run by the Florida Healthy Kids Corp. in coordination with the Agency for Health Care Administration, Department of Children and Families and Department of Health.

Participants would be able to choose their own insurance plan and pay minimal monthly premium and co-pays, though an exact amount is not known. As part of Negron's proposal, the state would have to submit its plan for federal approval by June 14. The program would expire at the end of any fiscal year in which the federal government breaks its funding level promises.

As part of the health care law, the federal government proposed expanding Medicaid for people making up to 138 percent of the federal poverty level. To do so, it would pay 100 percent of the costs for the first three years and taper down to 90 percent of the costs in 2020 and beyond. Though Scott voiced support for the expansion, Senate and House Republicans objected — effectively killing the idea.

House Minority Leader Perry Thurston said he supports the Healthy Florida compromise and hopes the House leadership will sign on to the Senate's plan. "Whatever you want to call it, if it provides the services to the needy members of Florida's society, we're all for it," Thurston said during a pro-Medicaid expansion rally with faith leaders Wednesday.

House Republicans could be a hard sell. Leaders there have said they are willing to forgo the federal money.

"The idea that the federal government can buy off states — buy us off with money, so-called 'free money' — and that somehow they will make us more dependent and more entitled is a bad thing for the state of Florida," House Speaker Will Weatherford told a tea party-affiliated group Tuesday. "And I'm here to tell you the state of Florida will not do it, American should not do it, and we should turn back any Medicaid expansion money."

On Wednesday, Weatherford would only say through a spokesman that a House committee studying health care will "take a close look" at the Senate's proposal.

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

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