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Now is the time to expand Medicaid

Chances are, the governor would like Linda Deyber.

She's spunky and sharp. She comes from a rock solid Republican background, and raised two kids while working the past 25 years or so for property management companies.

Everything about her screams middle class, a salt-of-the-earth conservative who would fit nicely among Gov. Rick Scott's core support groups.

Except for this:

She says she lost her job last year because of an ongoing gynecological health problem. Now, after exhausting her savings and draining her retirement account, she faces even more surgery and has neither the insurance nor the funds to pay for it.

She can't resume work without surgery, and she can't have surgery without money. Deyber, 53, is caught in a spiral that she fears will soon leave her homeless.

"I'm not mad, I'm sad. Sad to see it's happening to me, and sad to know it's happening to other people,'' Deyber said. "I know the negative stigma. I know there are people who will say I just want to live off the government. Or I don't want to work.

"Trust me, I know that's how people think. Once upon a time, I said those words myself. I just never thought I'd be living it. Crying in a Social Security office for someone to help me.''

In spite of the tears running down her face, this is not simply a sob story.

It is a policy story. A facts and figures story. A common sense story.

The U.S. Supreme Court has left it up to individual states to decide whether they will accept the federal government's offer to expand Medicaid protection to include adults with incomes near or below the federal poverty line.

The government will pay the entire cost of Medicaid expansion for the first three years, and then pay 90 percent of the cost with states being responsible for the other 10 percent.

A detailed economic study from Georgetown University says expanding Medicaid will actually save money in Florida during the next decade because it will eliminate costly safety net programs while also increasing overall health with preventive care.

It will also mean federal tax dollars paid by Floridians will be used for health care in this state, instead of being shipped to New York or California or dozens of other places.

Finally, it is estimated this expansion will create 54,000 new jobs in Florida.

And yet Gov. Scott and the Florida Legislature are undecided.


The governor used to say expanding Medicaid would cost the state tens of billions of dollars. Once that argument was discredited, Scott has been mostly silent.

"Forget all of those other reasons to expand Medicaid. We should do this because we're supposed to help people, period,'' said state Rep. Mike Fasano R-New Port Richey, who has written letters to hospitals and physicians on behalf of Deyber and others. "We have a responsibility to people like Linda to get the help they need.

"We should not be turning our backs on people until they're crawling to the emergency room, down to their last breath.''

The best current alternative for those without insurance or funds is to simply show up at hospital emergency rooms where they cannot be denied care.

Hardly anyone – including those opposed to Medicaid expansion – believes emergency rooms are the answer. And that situation will only worsen when the Affordable Care Act is instituted and safety net funds to hospitals are cut.

The CEO for Sarasota Memorial Health Care System was one of four hospital executives to appear before a Senate panel this week in Tallahassee. He said about 30 percent of the hospital's patients and half of the emergency room visits were uninsured customers, costing Sarasota Memorial $84 million in uncompensated care.

Ohio Gov. John Kasich, one of six Republican governors who have announced support for Medicaid expansion, said bypassing those funds would create "financial chaos'' for hospitals that treat a high number of uninsured patients.

Arizona Gov. Jan Brewer also talked about safety-net hospitals, and said she was supporting expansion because she did not want Arizona's federal tax dollars being used in other states. Other Republican governors have said Medicaid expansion made sense from both a financial and a compassionate standpoint.

In Florida, we're still waiting to hear.

Waiting to hear a legitimate reason why we shouldn't proceed with a plan that independent experts say will save the state money, reduce the burden on emergency rooms and keep our citizens healthier and more productive.

"I will never look down upon anyone ever again needing assistance. Never again,'' Deyber said. "It's been hard trying to convince people that, 'No, I'm not trying to take advantage of the system.' I would love to go back to work.

"My kids always saw me as this strong, authoritative, stable person who was able to provide. And now I'm at their mercy. This whole ordeal has destroyed the person I was.''

Now is the time to expand Medicaid 02/16/13 [Last modified: Tuesday, February 11, 2014 3:08pm]
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