1. Opinion

Bill Nelson: Expanding Medicaid good for Florida's health, economy

Published Apr. 18, 2014

Among our fellow Floridians, our neighbors, there are roughly 764,000 low-income people whose misfortune is compounded by the fact they are without health care coverage.

The meager amount of money they do earn makes them ineligible for both Medicaid, the federal government's health insurance program for the needy, and for premium assistance under Obamacare.

As a result, many of them may lack access to routine medical care. And tragically, truth be told, some Floridians will die as a result of not expanding Medicaid.

The number of preventable deaths in Florida is somewhere between 1,158 and 2,221, according to a study by researchers from Harvard Medical School and Hunter College, who relied on various sources to arrive at that mortality estimate.

No member of either political party can claim victory here. Nor should our Republican governor and legislative leaders continue opposing the expansion of Medicaid — because honestly, there is no real reason to do so.

To be fair, Gov. Rick Scott has said he cannot "in good conscience" oppose expanding Medicaid. But he is certainly ignoring the issue.

While a number of other states likewise under Republican control — Arizona under Gov. Jan Brewer, for example — have found a way to expand health care coverage for their low-income residents, Florida has not.

Recently I received a letter from the federal government stating it is "ready and willing" to work with Florida on a state-designed plan for expanding Medicaid. I immediately sent a copy of the letter to the governor, to House Speaker Will Weatherford, R-Wesley Chapel, and Senate President Don Gaetz, R-Niceville, urging them to move Medicaid expansion forward.

I even offered them a possible solution. The idea, broadly speaking, is to have local public hospitals, which already care for many of the indigent, pledge a portion of their revenue to provide the matching funds required of the state for Medicaid expansion.

There still may be time in the current Tallahassee legislative session to consider this or other alternative plans. In fact, state House Democratic leader Perry Thurston of Plantation has suggested a conference panel on the state budget include talks on Medicaid expansion. And he's asked his colleagues in the leadership to consider a special session so that state lawmakers can give their full attention to expanding health care coverage.

As Florida's former insurance commissioner, I can tell you I have seen firsthand that people with unattended sickness find it more difficult to work and to be productive citizens, and kids lacking basic medical care cannot learn as well as other children and often face a more uncertain future.

Besides the basic notion of helping people in need, the state as a whole would benefit from reclaiming some $51 billion in federal funding that, absent Medicaid expansion, is going to other states. That money is currently slipping away from Florida at the rate of about $7 million a day.

Additionally, Floridians would see opportunities for new well-compensated jobs in health care and related industries. A University of Florida study estimated that over 10 years some 121,945 new jobs would result from Medicaid expansion. And Sen. Gaetz himself has acknowledged "if state lawmakers decide not to accept the (federal) money, more than 100,000 high-paying medical jobs may not come to Florida."

In fact, some of our state's largest employers, including Walt Disney World, Publix Super Markets and Florida Power & Light, have been part of broader coalitions that have acknowledged support for expanding health care coverage to more low-income residents.

While the state Senate did have a bill last year that may have been workable, it was the unwillingness of the state House that ultimately was responsible for a final solution falling short of the governor's desk. The House Republican leadership insisted on charging a significant premium to people below 100 percent of the poverty line — something not allowed by existing law.

Doesn't the Good Book say that when we gather the harvest we should at least leave the gleanings for the poor?

Hopefully, the governor and state lawmakers will heed the words of President Franklin D. Roosevelt and remedy this callous decision.

"The test of our progress," Roosevelt said, "is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little."

U.S. Sen. Bill Nelson, a Democrat, is Florida's senior senator. He served in the Legislature as well as the state Cabinet. He wrote this exclusively for the Tampa Bay Times.


  1. The Howard Frankland Bridge, which connects St. Petersburg and Tampa, is a leading symbol of regional unity.
    Organizations that rebrand themselves should have a regional mission that reflects the name.
  2. The White House says it has chosen President Donald Trump's golf resort in Miami as the site for next year's Group of Seven summit.  (AP Photo/Alex Sanz, File) ALEX SANZ  |  AP
    Monday’s letters to the editor
  3. Academy Award-winning actress Lupita Nyong'o has written a children's book called Sulwe, about a girl who "was born the color of midnight."[Photo (2014) by Jordan Strauss/Invision/AP] File photo
    Most white people have never heard of skin lightening cream or the “paper bag test,” where your fiance can be no darker than a paper sack. | Leonard Pitts Jr.
  4. Ayana Lage, 26, and Vagner Lage, 27, pose with a sonogram of their unborn child. Ayana writes openly about going through a miscarriage due to the baby having a rare genetic defect. She wonders why more women don't discuss their miscarriages. JOHN PENDYGRAFT   |  Times
    Sunday’s letters to the editor
  5. Kreshae Humphrey, 26, applies ointments to the skin of her 3-year-old daughter, Nevaeh Soto De Jesus, after bathing her in bottled water. The parents bathe all three of their girls with bottled water because they believe the children were sickened by the tap water at the Southern Comfort mobile home park off U.S. 19 in Clearwater. The family is suing the park's owner over the issue, but the owner and the state say there are no problems with the drinking water there. MARTHA ASENCIO-RHINE  |  Times
    The story of a Clearwater mobile home park and its water issues reflects a systemic breakdown.
  6. A long stretch of US 98 remains closed for repairs in Mexico Beach on Friday, September 27, 2019, almost one year after Hurricane Michael made landfall in the small coastal town. DOUGLAS R. CLIFFORD  |  Tampa Bay Times
    Time is running out, so let’s get practical, says Craig Fugate
  7. FROM PRINT: Adam Goodman, national Republican media consultant
    Sure, fix capitalism’s flaws, but a wealth tax is not the way. | Adam Goodman
 CLAY BENNETT  |  Chattanooga Times Free Press
  9. A view of the downtown St. Petersburg skyline and waterfront from over Tampa Bay.
    The news that the Tampa Hillsborough Economic Development Corporation wants to change its name to include “Tampa Bay” has been met with resistance.
  10. Catherine Rampell, Washington Post columnist.
    Allegations of political cowardice can seem rich coming from candidates unwilling to acknowledge the obvious truths about things such as higher taxes. | Catherine Rampell