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  1. Opinion

Column: Florida should expand access to health care

There are more than 160,000 people in Tampa Bay in a predicament that can't be logically explained: They make too much money to qualify for Medicaid and too little for subsidized health insurance on the federal insurance exchange.

They are in what we call the "coverage gap." And because they are in this gap, they have access to health care services only on an emergency basis. No one wants to be in this situation.

While Florida has struggled to find a solution, other states have enjoyed benefits that come with health care expansion. In those communities, people who had been uninsured are now visiting their doctors. Millions of Americans are receiving preventive care that had been reserved for those fortunate to have employer-provided insurance.

As a result, cancers are being detected. Diabetes is being treated. Chronic conditions are being averted. These changes deeply impact the people receiving care. And when costly chronic conditions are managed more effectively, a healthier and more productive workforce contributes to society.

I was in Tallahassee often during the 2013 legislative session as state senators and representatives debated pros and cons of health care expansion. I heard the concerns from elected officials who theorized that expanding health care would be detrimental to our state. Though many of those same arguments are still being made, we are finally seeing the law in action and the positive impact it is having on states around the country.

As of today, 27 states plus the District of Columbia have elected to expand health care coverage under the Affordable Care Act. Another five states are in conversations with the federal government to develop state-specific plans to expand. The results in those expansion states are dramatic and worth paying attention to.

Here are the facts: Since the beginning of this year, the number of uninsured people is dropping at double the rate in states that have expanded Medicaid. As a result, the rate of uninsured patients showing up at hospitals in expansion states has dropped by a third. Hospital charity care in those states is dropping, meaning there is less of a cost shift to employers and workers with private health insurance. The health insurance premiums for plans sold through the exchange in expansion states are growing at a slower rate than states that haven't expanded.

Since the Florida Legislature chose not to expand coverage, it appears Floridians who have obtained insurance through Healthcare.gov will pay more than they would have otherwise.

Not only are expansion states seeing dramatic improvements in early health outcomes, many states have taken advantage of the flexibility provided by the federal government to expand health care in a manner that makes sense for their state.

In Arkansas, the expansion population is able to buy private health insurance through the state's exchange. Pennsylvania's expansion plan was approved with a provision that will provide greater incentives for recipients to engage in healthy behavior and find a job if they don't have one already. Indiana is reportedly in discussions to expand health care through the existing Healthy Indiana Plan, which is comparable to a consumer-driven health plan with an accompanying health savings account.

Many of those who opposed expansion the last two sessions did so out of concern that the federal government wouldn't be flexible or that the cost of charity care wouldn't go down. But those concerns have not been realized. We now have the evidence to prove the effectiveness of health care expansion.

Floridians are hungry for affordable and comprehensive health insurance. We need look no further than the high levels of enrollment during the most recent Healthcare.gov open enrollment season. Despite the early troubles with the website, more than 900,000 Floridians signed up for Obamacare insurance. The Florida Office of Insurance Regulation expects the number of enrollees to grow by 25 percent next year. But an almost equal number remain in the coverage gap.

The business community, as well, continues to show its support for health care expansion. Nearly 400 businesses representing over 100,000 employees, two statewide business organizations and 11 chambers of commerce, including the Clearwater Chamber, Tampa Chamber and St. Petersburg Chamber in our area, are on board.

It's time for our elected leaders to look at what has worked in other expansion states and craft a solution that works for Florida and increases access to quality health care for all of our citizens. If other states can find answers for expanding health coverage to their uninsured residents, why can't Florida?

Stephen R. Mason is president and CEO of the BayCare Health System.

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