1. Florida Politics

Romano: In Medicaid battle of wills between state House, feds, the poor lose

Published Dec. 15, 2015

As lawmakers show up for a new Legislative session this morning in Tallahassee, let's review where we stand on the issue of Medicaid expansion:

In the past week, the state's Senate majority leader and a spokesperson in the governor's office both sounded the alarm about a looming budget calamity.

Safety net hospitals are growing increasingly nervous about the potential loss of $1 billion in federal funds, and nearly 1 million residents are still without health insurance.

So what is the strategy in the state House of Representatives?

Double down on being elitist pinheads.

You may not see that printed on official House stationery, but it's pretty much the only logical conclusion.

For what's going on here is an expensive — and potentially life-and-death — game of chicken.

By refusing to address Medicaid expansion, Republicans in the House are essentially daring the federal government to stop providing that $1 billion in charity care to hospitals.

The House seems willing to let hospitals go in the red and patients go in the dirt, but it's betting it won't get that far because the feds have more of a conscience.

Basically, lawmakers are asking the White House:

Are you willing to be as miserably cruel as we are?

This is what passes for leadership in Tallahassee.

They're not concerned with compromise. They're not concerned with seeking an alternative solution. They're not concerned with low-income residents who are afraid to seek medical attention for fear of crippling hospital bills, and they're not concerned with jeopardizing the entire state budget.

You know what they're concerned with?

Winning this showdown.

So many of their excuses have been shot down over time that House members don't even like talking about Medicaid expansion because their reasoning sounds so lame.

They don't acknowledge that providing basic health care through emergency room visits is logistically foolish and fiscally insane. They don't acknowledge that low-income residents can avoid costly medical conditions and be more productive workers if they have some form of health insurance.

They don't acknowledge that hospitals, businesses, chambers of commerce and even the Republican-dominated state Senate have endorsed some version of Medicaid expansion.

Instead, the lone argument heard from these representatives of the state government is that you can't trust representatives of the federal government.

All of which puts Washington, D.C., in a bind.

Gov. Rick Scott's office seemed to acknowledge last week for the first time that it may not be able to count on Low Income Pool funding — the $1 billion in hospital safety net money — in its 2015 budget. And that's exactly why federal officials make that sort of threat to force states to get onboard with Medicaid expansion.

But considering the genesis of this entire plan was to provide better health care for needy residents, it's almost inconceivable to believe the federal government would now consider turning its back on those people simply to punish state legislators.

That would just be sleazy.

It sounds like something the Florida House of Representatives would do.


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