This is a tale of two Southern states with conservative Republican governors who oppose the Affordable Care Act. Florida and South Carolina have rejected federal money to expand Medicaid to cover more uninsured residents. They have refused to set up health care marketplaces and left the job to the federal government. Yet one state quietly finds ways to make health care reform work so its residents get coverage while the other tries to sabotage it.
Guess which one is more enlightened? Hint: It's not the state with more uninsured residents. It's not the one with more residents who are qualified for Medicaid now but haven't signed up. It's the one where Steve Spurrier coaches now, not the one where the Old Ball Coach used to throw his visor.
South Carolina officials are preparing for the coming changes to health insurance even as Gov. Nikki Haley opposes health care reform. They intend to encourage people to get coverage. Even without Medicaid expansion, the state has about 170,000 people eligible for Medicaid in the state who are not enrolled. Recognizing that poor residents may be seeking health coverage for the first time, the New York Times reports the state has doubled the staff at the call center for its Medicaid program. It has provided extensive training to those answering the phones, and it is rewiring its computers to connect to the online marketplace where residents may qualify for federal subsidies to buy insurance.
South Carolina also is enlisting hospitals to help get the uninsured coverage.
Florida has more than 220,000 residents who are Medicaid-eligible but not yet enrolled. Two-thirds of those are children. But Florida hasn't hired more staff to handle the call volume. Whitney Ray, spokesman for the state Department of Children and Families, says at "no additional cost to the state" the staff has been trained to send callers to the marketplace if they don't qualify for Medicaid.
Sounds like the "you're on your own" approach.
Florida has rejected millions in federal grants to help implement health care reform, and Gov. Rick Scott's breathless warnings about the dangers of seeking help to sign up with the marketplace may have a chilling effect. The governor complains that the navigators — experts who will help some of the 3.8 million uninsured Floridians sign up for health insurance on the marketplace — will endanger consumer privacy by collecting income and citizenship information. His administration also has tried to ban navigators from working in county health departments. But using a navigator is voluntary, and the process is similar to signing up for Medicaid, Florida KidCare and veterans benefits. The Obama administration has announced new controls to protect patient privacy that will mirror the protections in existing programs.
Chief Financial Officer Jeff Atwater is no fan of the Affordable Care Act and opposes expanding Medicaid. But at least he provides a small break from the partisan hostility. His office is offering a toll-free consumer help line with specialists to answer questions on the Affordable Care Act. That toll-free number is 1-877-MY-FL-CFO (1-877-693-5236), and Atwater also plans educational webinars for small business owners.
Two states. Two Republican governors who oppose health care reform. South Carolina still goes the extra mile to help its residents get the health care coverage they are entitled to receive. Florida doesn't even try — and the losers will be its businesses and its residents who need answers and health care coverage.