House Republicans held their ground and approved a bare-bones alternative to expanding Medicaid on Friday that rejects billions of dollars in federal assistance and sets up a showdown with the Senate and Gov. Rick Scott.
The House voted 71-45 to approve its alternative to Medicaid expansion, which uses up to $300 million a year in state funds to provide basic coverages to about 130,000 people.
The Senate plan, which Scott prefers, relies on $51 billion in federal money over 10 years to provide health insurance to 1 million or more Floridians. Senators could vote on their plan, and a third alternative, as early as Monday.
On Friday, House Republicans again made the case that Florida cannot rely on federal assistance and said their proposal was innovative and sustainable. "We've been presented with an opportunity here in Florida to do something revolutionary," said Rep. John Wood, R-Winter Haven.
Democrats, meanwhile, continued to criticize the House plan as inadequate for Florida's poorest families. The House plan covers only a fraction of the people included in the Senate proposal and includes premiums and deductibles that critics say poor Floridians cannot afford.
"This bill is wrapped in a beautiful box. The paper is beautiful. The bow is beautiful," said Rep. Mia Jones, D-Jacksonville. "But when you open that box up, the box is empty and it's filled with empty promises."
One Republican, Rep. Mike Fasano of New Port Richey, joined Democrats in opposing the House measure.
Plenty of uncertainty remains as the Legislature enters the final week of its scheduled 60-day lawmaking session.
While senators appear ready to pass their broader health care plan (SB 1816), they also could consider the House plan (HB 7169), or a third proposal (SB 1844) offered by Sen. Aaron Bean, R-Fernandina Beach, that is similar but not identical to what the House is offering.
Bean on Friday was planning to amend his proposal, though it was unclear how.
If no agreement is reached, lawmakers could return for a special session, wait until 2014, or do nothing at all. Federal money, which was offered as part of President Barack Obama's health care law, is not available until January 2014.
Another wildcard is Scott, who said he supports accepting federal aid but has been mostly absent from negotiations. Scott was in Washington Friday for media interviews and could not be reached.
A failure to reach an agreement will be seen as a disappointment, though it's unclear who will shoulder the blame.
House Speaker Will Weatherford, R-Wesley Chapel, and Senate President Don Gaetz, R-Niceville, say an all-or-nothing edict from the federal government is complicating negotiations.
As part of the health care expansion, the federal government is dictating who would qualify for the expanded health care provision and has said they will withhold federal money if a state leaves anyone off the list.
"You have a growing number of states that are asking the federal government for some kind of flexibility to fashion a solution that works in their state," Gaetz said.
Gaetz said Friday the House and Senate will continue to try to reach some agreement.
"Our door is open, our minds are open," Gaetz said. "And I know that Speaker Weatherford, as well, is reaching out and hoping that there might be a way that we can come together."