In West Virginia, Sharon Mills lacked health insurance and struggled to manage her diabetes until her state expanded Medicaid and she obtained coverage. In Florida, Jennifer Bates isn't as lucky. The Wesley Chapel resident lost her job in customer service in August and has no health coverage because her state representative, House Speaker Will Weatherford, blocked efforts last year to accept billions in federal Medicaid money. Advocates for the poor, business groups and the health care industry should keep pushing the Legislature to accept the Medicaid money and enable Bates and 1 million other Floridians to get access to health care.
Hundreds of thousands of Americans are taking advantage of expanded Medicaid in the 25 states that have embraced that provision of the Affordable Care Act, which requires the federal government to pay 100 percent of the cost for the first three years. In West Virginia, the New York Times reports, more than 75,000 have signed up for Medicaid. They include residents such as Mills, a disabled nurse, and Rachelle Williams, a 25-year-old uninsured McDonald's worker. Hard numbers are difficult to come by, because many new Medicaid recipients already were eligible for Medicaid and did not realize it until they sought private coverage in the federal marketplace. But studies show substantial portions of the new Medicaid patients are eligible only because of the expansion in the states that accepted the additional federal money.
In Florida, legislators passed up $51 billion over 10 years to expand Medicaid or subsidize private policies. That left people like Bates out of luck. Her unemployment benefits leave her with too little income to qualify for a federal subsidy to buy private insurance in the federal marketplace. The health care reform law anticipated people like her would be covered by the Medicaid expansion. The U.S. Supreme Court made Medicaid expansion optional for the states when it upheld the guts of the Affordable Care Act, and Florida is one of the Republican-led states that has chosen partisan politics over sound public policy and refused to participate.
Uninsured Floridians aren't the only ones hurt by this callous indifference. A new report estimates the failure to expand Medicaid could cost Florida businesses up to $253 million a year in tax penalties. The report by Jackson Hewitt Tax Service estimates about 84,000 uninsured Floridians work for large companies but cannot afford their employer's health coverage. They would qualify for expanded Medicaid, but since that is not available they can sign up for subsidized coverage on the federal marketplace. Those businesses face fines for each employee who gets a subsidy in the marketplace — fines they would avoid if Florida accepted the Medicaid expansion money.
The Senate passed a reasonable alternative by a 38-1 vote last year that would have used the expansion money to subsidize private coverage. Weatherford did not allow that bill to come to a vote in the House in the session's final days. Sen. Joe Negron, R-Stuart, led the effort last year but is not interested in renewing the fight. Sen. Rene Garcia, R-Hialeah, filed a similar bill last week, and the Legislature should give it a fair hearing. It is a fight worth fighting for Floridians like Bates and countless Florida businesses facing avoidable tax penalties. Florida should not be trailing West Virginia in health care reform and sound economic policy.