Florida House Speaker Will Weatherford is responsible for more than 150,000 of the poorest residents in Tampa Bay being cruelly excluded from health care coverage. While most of the region's uninsured are now mulling over their multiple options for health insurance coverage on the state online marketplace created by the Affordable Care Act, Weatherford's indefensible rejection of Medicaid expansion means the state's poor are out of luck. This gap in coverage is really a gap in compassion.
The health care reform law was designed to provide access to affordable, comprehensive health coverage to nearly everyone. The uninsured would shop for policies on the online marketplaces, which opened Oct. 1. People making between 100 percent and 400 percent of the poverty level would receive subsidies to help pay for coverage. Those making below the federal poverty line would be covered by the expansion of Medicaid, a federal-state program of health insurance for the poor.
The U.S. Supreme Court upheld most of the Affordable Care Act but allowed states to opt out of the Medicaid expansion. Florida and 25 other states, largely in the South and with Republican governors or Republican-controlled legislatures, declined to expand Medicaid. It was a heartless attack on 8 million of the nation's poor who are now stranded without coverage. They won't qualify for subsidized insurance on the marketplaces because they earn too little. The irony is that these states make up about half of the U.S. population but have two-thirds of the country's poor. It is their residents who would have benefited the most.
When the numbers are crunched, expanding Medicaid brings a financial windfall. The federal government picks up 100 percent of the cost for the first three years and no less than 90 percent in later years. Florida would have received $51 billion in federal funds over 10 years, a figure that got the attention of Gov. Rick Scott and Senate President Don Gaetz, both Republicans, who would have taken Medicaid expansion dollars. But Weatherford, a Republican from Wesley Chapel, refused to let the House even consider a bill passed 38-1 by the Senate to use the Medicaid money to help buy private insurance for the poor.
His decision leaves a million Floridians without Medicaid coverage. A New York Times analysis finds that among those falling through the Medicaid gap are 52,018 adults in Pinellas, 59,295 in Hillsborough, 29,367 in Pasco and 10,113 in Hernando counties. That's more than 150,000 people in the Tampa Bay area who would have coverage if Weatherford was not standing in the way. They earn paychecks that just aren't big enough to cross the federal poverty line. They are cashiers, restaurant staff, retail clerks, home health aides and cleaners. Florida is awash in these kinds of low-wage jobs. The people who do them work hard and have little to show for it. Now Weatherford's stubborn opposition to Medicaid expansion robs them of the medical security the law was designed to bring to all families. Florida is a smarter, more compassionate state than that.