The Florida Legislature opens its annual session today with Gov. Rick Scott's State of the State address and speeches from legislative leaders, but don't expect to hear a peep about the state's most important issue. They hope everyone forgets about the 1 million uninsured residents who would have health coverage if legislators would accept billions in federal Medicaid money. Floridians should keep reminding them of the sound moral and economic arguments for extending health coverage, even if they don't want to hear it in Tallahassee.
Now 25 states, including eight with Republican governors, have found a way to take the federal money and extend health coverage to more of their residents. The Obama administration approved a plan last month that is embraced by Michigan Gov. Rick Snyder, a Republican, and expands Medicaid but requires small co-payments and premiums based on income. Other states such as Arkansas have won permission to use the money to subsidize the cost of private insurance. Yet Florida remains stuck in neutral with a governor who refuses to lead and a House speaker who refuses to listen.
This time last year, Scott had just won federal approval to move all Medicaid patients into managed care and had endorsed taking the Medicaid expansion money. Then House Speaker Will Weatherford poisoned the debate by using his opening day speech to rip the expansion as a "social experiment" and leaving no room for compromise. The Senate still voted 38-1 for a workable plan to use the expansion money to subsidize private insurance, but Weatherford refused to take up the legislation in the final days of the session.
Today, uninsured Floridians are even worse off. Scott won't reaffirm his support for Medicaid expansion. Senate President Don Gaetz, R-Niceville, points to problems with the debut of the federal marketplace and suggests the Senate is no longer interested in the issue. Weatherford, R-Wesley Chapel, repeats the same illogical arguments he made a year ago. They complain the Obama administration is inflexible when it has been flexible in approving reasonable alternatives in Michigan, Arkansas and elsewhere. What the administration won't do — and shouldn't — is tighten the eligibility standards as Weatherford suggests and tell 400,000 uninsured Floridians they could not benefit from the Medicaid expansion money. That would be cruel and unusual punishment, but this is the same state government that is violating federal rules by limiting emergency room visits by Medicaid patients.
The case for Florida to accept billions in federal money over the next decade has gotten stronger. It would create thousands of jobs, and the federal government still would pay the entire cost for three years and never less than 90 percent of the bill after that. The NAACP, the Florida League of Women Voters, the Florida Chamber of Commerce and the health care industry support the expansion. What is lacking is the fortitude in Tallahassee to stand up to the Republican leadership. The governor won't do it, so Floridians have to raise their voices. And if there is no action on Medicaid expansion this spring, voters can respond appropriately in November.