For the first time, members of the Florida Medical Association have approved a resolution endorsing Medicaid expansion, a politically contentious issue that the group's leaders have generally avoided in the past two legislative sessions.
But the FMA's full-throated support for expansion comes with a caveat: Medicaid reimbursement rates must be increased to attract more doctors to the program.
By unanimous voice vote at the FMA's annual conference in Orlando, several hundred members on Sunday approved a resolution written by South Florida obstetrician-gynecologist Aaron Elkin. That statement says the FMA will publicly support expanding Medicaid eligibility as long as the program "safeguarded patient access to care" by increasing rates to the same level as those paid by Medicare, the federal insurance program for seniors and the disabled.
The resolution, which had the support of several South Florida medical societies, had been recommended by an FMA committee on Saturday.
A statement from FMA general counsel Jeff Scott focused on the part of the resolution calling for higher payment rates. The voting members are known as the House of Delegates and include representatives of county medical societies and specialty societies.
"In passing this resolution, the House of Delegates recognized that increased access to care for an enlarged Medicaid population will only come about if there are adequate numbers of physicians to care for these patients," Scott said. "It is also understood that current payment levels (which in many instances do not cover the cost to provide care) are grossly inadequate and serve as a disincentive to physician participation in the Medicaid program."
The politically influential FMA has in the past reserved its considerable lobbying firepower for other issues, such as malpractice reform. On Monday, the group's executives acknowledged the weekend vote only after an advocacy group tipped off reporters.
Some Republican leaders, including House Speaker Will Weatherford, are adamantly opposed to giving Medicaid coverage to a greater number of low-income, childless adults. A spokesman said Monday that the House position has not changed. Senate leaders have expressed interest in using federal funds to buy private insurance for the new Medicaid beneficiaries, and Gov. Rick Scott has said he favors that option, as well.
Although it is a key component of the Affordable Care Act, expanding Medicaid eligibility was left up to the states, which administer the program jointly with the federal government.
Florida's refusal to expand the program leaves about 800,000 Floridians without health insurance, as they can't qualify for Medicaid under current rules and are too poor to qualify for federal tax subsidies that help pay for private insurance.
Elkin, chairman of the Broward County Medical Association's board of trustees, said his resolution tied together two issues — expanded eligibility and the statewide rollout of managed care for nearly the entire Medicaid population — for practical reasons.
The state program already suffers from the fact that only a limited number of physicians will accept Medicaid because of the low reimbursement rates, Elkin said. He argues that accepting the federal expansion funds — $51 billion over a decade — would address major problems with the program. Not only would managed-care companies get more customers, but the increased funding would provide more attractive rates for doctors.
With the resolution's approval, Elkin says the FMA can no longer stand on the sidelines of the Medicaid debate.
"To make it clear, the doctors in Florida have spoken," he said.
The FMA last year released a survey of its members showing that a majority — 58 percent of respondents — supported Medicaid expansion. But only 3 percent said it was the most important issue the group should focus on at the moment.
Doctors for America, a national group that advocates for Medicaid expansion, released a statement supporting the move. The group counts a number of Florida physicians among its members, including chairwoman Dr. Mona Mangat, a St. Petersburg allergist.
"The Florida Medical Association sent a resounding message about the importance of increasing access to health care for nearly 1 million Floridians. Doctors across Florida are united in expanding access to care because we know this is the right move for our patients and our state," Mangat said in the statement.
"We applaud the FMA for this vote and look forward to working together in the upcoming legislative session to fight for the 2,200 Floridians who will die this year … because they do not have access to the care they need."
Times staff writer Tia Mitchell contributed to this report. Contact Jodie Tillman at [email protected] or (813) 226-3374.