Don't be fooled by Florida Republican legislators who defend their refusal to accept Medicaid expansion money as a responsible conservative position and criticize the Obama administration for being inflexible. Another conservative Republican governor, Mike Pence of Indiana, proposed last week that his state use the federal money to help provide insurance for low-income Hoosiers. It's not conservative values or rigid Washington depriving poor Floridians of health coverage; it's political stubbornness and insensitivity in Tallahassee.
Pence was one of the most conservative members of the U.S. House before being elected governor of Indiana in 2012. He vigorously opposed the Affordable Care Act in Congress. And like Florida, Indiana declined to create its own online marketplace for private health insurance and forced its residents to use the federal exchange. Yet Pence has seen the light and proposes using the federal Medicaid money to help 350,000 low-income adults get health insurance through an existing state program. Indiana would require small contributions to monthly premiums, depending on income. The federal money would cover most of the cost, and the state eventually would pay for its share of the expanded program with an existing cigarette tax and hospital fee. There are issues to be resolved, but the Indiana governor has a workable framework and the Obama administration appears receptive.
Compare the conservative pragmatism in Indiana to the misguided ideological purity in Florida, where Republican Gov. Rick Scott fails to lead and the Legislature refuses to act. Scott has been silent on accepting $51 billion in Medicaid expansion money since embracing it more than a year ago. The Legislature failed to hold a single hearing on the issue this year, as unrepentant House Speaker Will Weatherford refused to consider viable alternatives. The result is that more than 800,000 uninsured Floridians earn too much to qualify for Medicaid but too little to qualify for federal subsidies to help buy insurance in the federal marketplace.
Weatherford, R-Wesley Chapel, and Senate President Don Gaetz, R-Niceville, complain that the Obama administration is too inflexible. That argument is not grounded in reality. The Department of Health and Human Services has approved a plan similar to the Indiana proposal for Michigan and a private coverage alternative for Arkansas. The Republican governors in Pennsylvania and Iowa are also floating proposals to accept Medicaid expansion money. It's the Florida Legislature that has proven to be unimaginative and inflexible, not Washington.
The thirst for health care coverage in Florida is obvious. More than 983,000 Floridians signed up for coverage on the federal marketplace, twice as many as expected and more than any other state using the federal website, healthcare.gov. Another 180,000 Floridians discovered they are eligible for Medicaid now. Yet the governor and the Legislature refuse to accept billions in federal Medicaid money to extend coverage to hundreds of thousands of uninsured Floridians. That is morally and economically indefensible.
Fortunately, there is an election in November. That will be the best opportunity for voters to hold the governor and state lawmakers accountable for failing to act in the best interests of the state and its residents. If Indiana can find a way to accept Medicaid expansion money to provide health insurance for its low-income residents, so can Florida.