House Republicans rejected a bipartisan Senate proposal to accept $51 billion in federal health care money on Thursday, diminishing hopes that lawmakers will reach a health care compromise before the legislative session ends next week.
After five hours of targeted questions and impassioned debate, Republicans rejected an attempt by renegade Republican Rep. Mike Fasano to accept the Senate plan to provide federally subsidized health coverage to more than 1 million Floridians.
The New Port Richey Republican urged his colleagues to "follow your heart" and support the Senate plan, but only Democrats joined him. They accused Republicans of rehashing the debate on Obamacare and the national debt, while denying poor constituents access to health care.
"Frankly, this is disgusting that this chamber is not taking up something that has been thought out, something that is bipartisan, something that will save lives, something that will help the state save a few bucks," said Rep. Mark Pafford, D-West Palm Beach.
Instead, House Republicans are sticking with their own plan that uses up to $300 million a year in state money to buy basic coverages for about 130,000 low-income Floridians. House Republicans expect another 400,000 people to receive tax breaks to purchase insurance using federal health exchanges.
House Republicans described the Senate plan, sponsored by Sen. Joe Negron, R-Stuart, as irresponsible, saying it relies on a federal government that can't manage its spending and could worsen an existing physician and nurse shortage. Though Negron's plan does not expand Medicaid, Republicans argued that his plan would further drive up state Medicaid spending.
"Call it whatever you want, but this amendment is still Medicaid expansion," said Rep. Matt Hudson, R-Naples.
Rep. Jason Brodeur, R-Sanford, said the Senate plan would saddle the state budget over the long term if the federal government is unable to meet its financial commitments. "What happens when we are forced to pick up the tab that we cannot afford?" he said.
Republican leaders of both chambers continue to say they are open to the possibility of compromise and that discussions are ongoing. But the sides remain far apart on whether to accept federal health care money and just who should benefit from taxpayer-supported health care.
House Speaker Will Weatherford, R-Wesley Chapel, said he is not sure whether the two sides can reach a middle ground, especially if the Senate insists on federal assistance.
"If compromise looks like taking $7 billion of money that is unsustainable, we don't think that's a compromise that the House can get to," he said.
Rep. Richard Corcoran, the architect of the House plan, has huddled with Negron and Sen. Aaron Bean, who drafted a third option similar to the House proposal, to talk about compromise options in recent weeks. Gov. Rick Scott, who supports accepting the federal money, has largely been absent from negotiations.
"We get together ... we talk together," said Corcoran, R-Trinity.
The state-funded component of the House plan only covers parents and the disabled, leaving out roughly 400,000 childless adults that would be covered under the Senate plan. Providing coverage for childless adults, either using state or federal funds, appears to be a deal-breaker in the House.
"There is a real good reason why we should move cautiously with that population," Corcoran said, adding that childless adults are more expensive to cover and the least needing of government support.
Bean, R-Fernandina Beach, said he hopes to propose an amendment to the House plan to make it more palatable to the Senate. But he believes likely no measure will have enough support to pass both the House and Senate.
The House is expected to pass its plan today, while the Senate is expected to pass Negron's proposal Monday. The chambers have until May 3 to strike a deal before the scheduled end of the 60-day legislative session.
On Thursday, Fasano argued that the House plan is unrealistic for poor Floridians and could mean that many remain without coverage. Families in poverty may not be able to afford $25 monthly premiums, let alone deductibles that could reach into the thousands, he said.
"This plan that they're offering you today, members, doesn't work," Fasano said. "Let's not fool ourselves."
Contact Tia Mitchell at firstname.lastname@example.org.
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Differing health care plans
|Who would be eligible?||Who pays?|
|Option||Proposed by||What is it?||How many people would be covered?||Adults between 100% and 138% of the federal poverty level (single person $11,490-$15,856)||Parents under 100% of the federal poverty level (less than $15,510 for family of 2)||Disabled Floridians under 100% of the federal poverty level (single person under $11,490)||Childless adults under 100% of the federal poverty level (single person under $11,490)||Premiums and co-pays||10-year cost to state||10-year cost to federal government|
|Senate plan (SB 1816)||Sen. Joe Negron, R-Stuart||Creates a new state-based health insurance program for the uninsured.||Anyone who is eligible would be able to enroll. The eligible population is the same as for Medicaid expansion, meaning enrollment could reach 910,324 by 2023.||Yes||Yes||Yes||Yes||Premiums $15-$20 a month; co-pays $10 or less.||$3.5 billion||$51 billion|
|Senate plan (SB 1844)||Sen. Aaron Bean, R-Fernandina Beach||Creates a state program to help the uninsured pay for basic coverages by subsidizing the costs.||Roughly 550,000 are eligible, but funding would limit the number that are able to enroll. Bean wants enough money to cover about half.||No*||Yes||Yes||Yes||Premiums at least $20 a month; state would contribute up to $120 annually.||$300-$400 million (estimated)||0|
|House plan (no bill number)||Rep. Richard Corcoran, R-Land O' Lakes||Creates a state program to help the uninsured pay for basic coverages by subsidizing the costs.||Anyone who is eligible would be able to enroll. The House estimates the program will grow to 130,000 people by 2023.||No*||Yes||Yes||No||Premiums $25 a month. State provides $2,000 annually.||$2 billion||0|
|Medicaid expansion (no bill number)||President Barack Obama||Expands the existing Medicaid insurance coverage to more Floridians.||Anyone who is eligible would be able to enroll. State analysts estimate that 910,324 people would enroll by 2023.||Yes||Yes||Yes||Yes||Usually no premium; co-pays $1-$3 for most visits.||$3.5 billion||$51 billion|
*Adults making over 100% of federal poverty would be eligible to purchase insurance on health exchanges using federal subsidies.