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One month later, Florida lawmakers no closer to Medicaid deal

TALLAHASSEE — Two House Republicans unwittingly revived hopes this month that lawmakers could compromise on a proposal to expand Medicaid.

"Lawmakers say Medicaid expansion not dead" read the headline in the Sarasota Herald-Tribune, highlighting comments from Manatee County Reps. Greg Steube and Jim Boyd.

But the reality is no different today than it was when the legislative session ended last month:

Medicaid expansion, or some alternative, remains a long shot.

"All I was simply trying to say was, we all agree it's an important issue," Boyd told the Times/Herald about his remarks at a June 6 luncheon. "We thought we had a pretty good plan."

That plan, championed by House Speaker Will Weatherford, included saying no to $51 billion in federal money over 10 years. Instead, House Republicans proposed using up to $300 million in state funding to subsidize basic coverages for about 130,000 people.

The Senate and Gov. Rick Scott rejected the idea out-of-hand, just as House Republicans swatted away any attempt to include federal money to expand health care to 1 million or more Floridians.

Both Boyd and Steube told constituents they would be open to a special session to try to reach some agreement. But several House members told the Times/Herald that is unlikely unless Weatherford, R-Wesley Chapel, hears an offer he likes.

House leaders insist it's the federal government, not they, that needs to bend. They want the U.S. Department of Health and Human Services to approve plans that qualify for some, but not all, of the Medicaid expansion funding. In particular, House Republicans are hesitant to provide subsidized health care to childless adults.

"I think they need to give the states more flexibility," said Rep. Richard Corcoran, R-Land O'Lakes, a top Weatherford ally who crafted the House plan.

While Florida lawmakers remain at a standstill, other states are pushing forward with Medicaid expansion. In Arizona on Thursday, a coalition of moderate Republicans joined Democrats to extend coverage to 350,000 low-income residents.

There, the issue was resolved only after Gov. Jan Brewer, a Republican who once opposed the health care law, called the Legislature into special session. She did so without the blessing of Republican leaders but after she became concerned that the regular session would end without an agreement.

Twenty-three states and the District of Columbia are moving forward with Medicaid expansion, according to the Kaiser Family Foundation, while Florida is among 20 that are not. The remaining seven are undecided.

Rep. Mike Fasano, R-New Port Richey, is the only House Republican to publicly support using the $51 billion from the federal government to expand Medicaid. He said he thinks the Legislature will eventually reach an agreement, but, "It's not going to happen anytime soon."

"I believe that when businesspeople start hearing this, the local chambers of commerce and other business groups, I think the pressure will start to build," Fasano said. A provision in the law requires businesses to provide health care coverage to some employees who may have qualified for Medicaid or face steep fines.

Although Florida has not expanded Medicaid, it is moving forward with a massive overhaul of the existing program. On Friday, the state received the waiver it needed from the federal government to transfer 3 million Medicaid participants to private managed care companies. Lawmakers hope this will help reduce program costs.

Florida received conditional approval of its Medicaid waiver in February, and Scott decided to announce his support for accepting federal expansion dollars that same day.

Contact Tia Mitchell at tmitchell@tampabay.com.

One month later, Florida lawmakers no closer to Medicaid deal 06/14/13 [Last modified: Friday, June 14, 2013 8:41pm]
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