Florida has three days to measure up to Arkansas. In Arkansas, a Republican-led legislature and a Democratic governor agreed to accept federal Medicaid expansion money to help buy private insurance for low-income residents. In Florida, the state Senate on Tuesday overwhelmingly voted for a similar plan that has been endorsed by Republican Gov. Rick Scott. It is a conservative, fiscally responsible approach, and the House should approve it before the regular session ends Friday.
The Senate's 38-1 vote to accept billions in federal Medicaid money to help provide health coverage to nearly 1 million residents sends a powerful bipartisan message and reflects mainstream Florida. The Florida Chamber of Commerce, Associated Industries of Florida, the health care industry and a majority of state voters favor taking the federal money. There is still time for House Speaker Will Weatherford and his allies to recognize this is a pragmatic solution and accept this compromise without jeopardizing their conservative credentials.
The financial case for accepting the Medicaid money is strong. Florida would receive $51 billion over the next decade, and the federal government would pay the entire cost of the expansion for the first three years. Washington also would pick up the cost of the Medically Needy program, which costs the state $430 million a year. The millions the state would save could be spent on other priorities or cover the state's modest matching costs in future years. Accepting the money also makes it less likely Florida employers with 50 or more workers that don't offer health insurance will face tax penalties under the Affordable Care Act. This should appeal to conservative legislators who pride themselves on being fiscally conservative and business-friendly.
The positive effect on Floridians is just as compelling. The Senate proposal would initially cover more than 438,000 low-income residents next year and roughly 1 million over the next decade. Health insurance leads to better access to preventive care and a healthier, more productive workforce. And the Medicaid expansion would create thousands of jobs as the health care industry expands to accommodate newly insured residents.
The arguments against accepting the Medicaid expansion money from Weatherford, R-Wesley Chapel, and his Republican allies are not persuasive. They criticize Medicaid as expensive and inefficient, but the Senate plan would use the federal money to buy private coverage. They complain about the federal deficit and distrust Washington, but there is no reason to believe the federal government would renege on its Medicaid commitment. They oppose providing coverage to low-income adults without children, suggesting those adults should work harder so they can afford insurance. Hundreds of thousands of those Floridians are working hard at low-paying jobs that don't provide coverage, and they deserve access to health care as much as their better-paid neighbors.
Sen. Joe Negron, R-Stuart, crafted a reasonable alternative to expanding Medicaid that still allows Florida to accept the federal money and cover nearly 1 million residents with private insurance. If Weatherford allowed Republican House members to vote their conscience, there is every reason to believe enough mainstream Republicans would join Democrats to approve the legislation. Democrats frustrated over the deadlock on Tuesday afternoon slowed down the House, forcing every bill to be read in full. Maybe that got Weatherford's attention. Does the first House speaker from Pasco County in more than a century really want to be the one who turned down $51 billion and turned his back on Floridians?
If the Legislature rejects the Medicaid expansion money, the difference between Florida and Arkansas will be clear - and it won't favor Florida.