Moderate House Republicans key to any state health care deal

TALLAHASSEE — After weeks of posturing and debate, the decision to expand Medicaid in Florida or accept $51 billion in federal health care money might rest with a moderate bloc of a dozen or so House Republicans.

And they're not saying a lot, at least publicly.

While Senate Republicans appear willing to join Democrats in supporting a massive health care expansion, many House Republicans serving in moderate districts have yet to vocally embrace or reject federal assistance.

A union supporting health care expansion already is targeting them with TV ads in an attempt to influence their vote. But the group also is hearing from conservative Republicans, who oppose accepting federal money.

A plan to take federal assistance requires 60 votes in the House, a majority because one seat is vacant. That means House Democrats need 16 Republicans to join their 44-vote bloc.

Freshman Rep. Kathleen Peters, a moderate Republican from the tiny beach town of South Pasadena, feels like she's on the campaign trail again, defending herself against negative attacks.

TV ads produced by SEIU Florida, a labor union, accuse Peters of "putting politics ahead of working families" in opposing Medicaid expansion.

The problem is, Peters said, she hasn't made up her mind how she'll vote.

"To be just filling the airwaves with tabloid sensationalism when we haven't even taken a vote on that issue to me is shameful," she said.

Peters is among a half-dozen GOP lawmakers being targeted in ads in Democratic-leaning districts, said SEIU Florida president Monica Russo. Russo said they were chosen because they are Republicans who should be most willing to accept federal money.

Peters' district supported President Barack Obama in 2008 and 2012 and Democratic gubernatorial nominee Alex Sink in 2010.

Other targets include Reps. Manny Diaz Jr. and Erik Fresen in South Florida, Bill Hager and Gayle Harrell on the east coast of the state and Ross Spano in Hills­borough County.

"I've got time yet to make a decision," Peters said.

Rep. Holly Raschein, a freshman Republican from Key Largo, appears to have made up her mind.

While House leaders, including Speaker Will Weatherford, R-Wesley Chapel, want the state to reject federal assistance, Raschein's constituents want the money, she said. She believes it could improve access to health care in the remote Florida Keys.

"I understand where leadership is coming from, not relying on D.C. for everything, and I completely get that argument," Raschein said. "But it's the law of the land and we must move forward. They're not going to spend it on Florida; somebody else is going to get it."

She could join Rep. Mike Fasano, R-New Port Richey, who has said he will attempt to force a floor vote on a plan to accept the federal money.

Florida "has the opportunity to help so many more ... that have been suffering for so long," Fasano said.

Other House Republicans representing moderate districts told the Times/Herald they had reservations about accepting the federal money or had not made up their mind.

Rep. Ed Hooper, R-Clearwater, said the growing national debt, which is nearing $17 trillion, makes him unsure about the government's ability to meet its longterm financial commitments. He supports the House plan, which uses only state funds to provide basic coverages to 130,000 people. Federal money could cover 1 million people or more.

Along with House lawmakers in moderate districts, supporters of expanding Florida's health care system are targeting Hispanic lawmakers who could be swayed.

Polls show that the health care law is popular among Hispanic voters. A January survey by the Florida Hospital Association found that 74 percent of Hispanics supported accepting federal funding, including 56 percent who said they felt strongly. A March poll by the business group Associated Industries of Florida found that 60 percent of Hispanics favored Medicaid expansion.

Speaking in both Spanish and English during a news conference last week, Rep. Victor Torres, D-Orlando, said Democratic lawmakers are "fighting for the Hispanic community, for the families, for the children" by insisting the House accept the federal aid.

Torres stood alongside three other Hispanic House members, but no Republicans.

It's a different story in the Senate, where Republican Joe Negron of Stuart has drafted a plan that accepts federal dollars and has bipartisan support. Republican Sens. Rene Garcia of Hialeah and Anitere Flores of Miami both voted in favor of the Senate proposal during last week's health care budget committee meeting.

The Legislature's Hispanic caucus met once this session, about a month ago. Torres said he brought up Medicaid expansion at the meeting and urged the caucus to take a position.

"My concern at that time is we should lead the charge of the Medicaid expansion, Republicans as well as Democrats," he said. "But they, at that time, felt that they were still waiting to see what was transpiring over here," said Torres, motioning toward the Senate chambers.

Torres is not sure if any Hispanic House Republican will break ranks. "I think it's going to be for them a tough issue to side with us," he said.

Diaz, the Hialeah Republican who is being targeted in television ads, said he does not want the state to rely on federal funds.

"Three years down the line, we don't want to be in the position where we come back in this chamber and we're in a position where we have to take something away because now we don't have the money and the federal government has pulled out on us," he said.

One thing that could cause a shift among House Republicans is a change of heart by Weatherford himself.

He has railed against the federal government's all-or-nothing approach to Medicaid expansion — which requires expanding health care coverage to childless adults in Florida for the first time — but he has also signaled that he would accept some federal money for a more limited program. A compromise like that would require the approval of the federal government.

Will it happen?

Like the vote count, it's hard to gauge.

"I think that Speaker Weatherford is so far out there, has taken many of the Republican members so far out to opposing taking any federal dollars, that this late in the game it's going to be difficult for them to come back to the middle, if you will, and accept either all or some of the federal dollars that are available to the state of Florida," Fasano said.

Times/Herald staff writers Steve Bousquet, Katie Sanders and Toluse Olorunnipa contributed to this report. Contact Tia Mitchell at tmitchell@tampabay.com.