Showdown looms over Medicaid | April 16
Health plan has drawbacks
State Sen. Joe Negron is to be commended for his creative effort to bring health care access to a million or more Floridians. As an architect and founding board member of Florida Healthy Kids Corp., I have two principal concerns with Negron's strategy of using the corporation as a health insurance exchange (marketplace) for adults in the Obamacare Medicaid expansion.
First, the proposal includes using the money from the Obamacare Medicaid expansion to pay insurance premiums for low-income Floridians. That strategy essentially repurposes Florida Healthy Kids Corp. as a health care exchange (marketplace). However, there will already be an Obamacare mandated health care exchange (marketplace) that Florida will have for privately funded coverage. If the $50 billion Medicaid expansion is to be used for insurance premium subsidies, why not use the Obamacare exchange for both publicly and privately subsidized Floridians? Why bear the additional cost (layer of government) of creating a separate exchange for publicly financed coverage?
Secondly, Florida Healthy Kids Corp. was built on the premises that children could be insured separately from their parents, and that insuring them separately would lead the insurers to focus on the unique health care needs of kids. There is a checkered history of health coverage mixing young kids and adults in the same risk pool. Simply put, kids and adults have different health care needs and require different providers. But because adults are more expensive to insure, private and public insurers historically focused their attention on adults to the near exclusion of kids. In Florida, policymakers recognized that bias by creating Children's Medical Services within government and Florida Healthy Kids Corp. in the private nonprofit sector.
Negron's policy direction is the right one, i.e., provide more Floridians with access to health care while supporting a major job-creating industry. The strategy of inadvertently dropping kids off the health care financing radar screen by repurposing FHKC will return us to the days when insurers regarded children as just "little adults" with needs no different from their parents. The strategy of expanding government by building a separate health care insurance exchange for Medicaid-subsidized Floridians is unnecessary because there will already be an exchange available to all Floridians as required under Obamacare.
Steve A. Freedman, Lutz
Showdown looms over Medicaid | April 16
House plan falls short
With all due respect to state Rep. Matt Hudson, when I read his remarks on the alternative to Medicaid expansion as proposed by the House Republicans, which he called "visionary," I had to laugh.
This proposed plan will insure about 130,000 new people versus about 1 million new people who would be insured under the Medicaid expansion. Two of the reasons given for refusing Medicaid expansion are that the federal government can't afford it and there is no guarantee it will make the payments as promised.
Whether the federal government can afford it or not is irrelevant as the money is already budgeted. If Florida refuses to use the federal money, it will go to some other state and will not reduce the deficit. As far as the federal government not making the promised payments, Medicaid has always been partially funded by federal money and there has never been a missed payment.
Several independent studies have stated that the Medicaid expansion provided for in the Affordable Care Act would create thousands of jobs and save money as the newly insured would no longer have to use the emergency room as their primary source of medical services. And other studies have shown that the hospitals, service providers and the majority of the people of Florida are for it. But the Republican-led Legislature is doing its best to block it. Shame on them.
Gerald Exstein, Land O' Lakes
Two explosions rock race's end | April 16
America will pull through
America over the last decade has experienced some of the most challenging and devastating tragedies in its brief 237-year existence. Yet amid all this chaos, there is hope for better days.
America has always gotten through trying times — not because of its wealth or power or "glorious" leaders, but because it has the strongest sense of community of all the nations on this planet. Americans are able to come together as one and unite for a common goal.
While it may not seem like that exists today, look at the videos of the Boston Marathon bombings and watch all the men and women run toward the explosion to come to the aid of those in need. I have faith in this nation because that strong sense of community that has gotten America through every trying era in her history is as present as ever today, and it will pull her through this difficult era as well.
Rylan Douthett, Bradenton