Column: Medicaid expansion not in Florida's interest

Published March 13, 2013

The United States Supreme Court struck down a portion of President Barack Obama's Affordable Care Act that mandated a massive expansion of Medicaid, and instead allowed each state to make a choice based on what is in its best interest. This means the Florida House and Senate will have an important decision to make this spring. Our actions have serious implications for the fiscal future of our state. Florida must decide if we will expand government-run health care for Floridians at a cost of $3.8 billion over the next 10 years.

Accordingly, both the House and Senate put together special bipartisan committees of legislators with a broad array of expertise on health care, insurance and financial matters. They met over the last few months to hear the facts. The Florida House was the first to identify the major flaws in the proposal. The committee recommended rejecting expansion. This week, the Senate did the same. Both the House and Senate have indicated a willingness to look for better options for our state.

We can all agree that Florida's existing Medicaid program plays a vital role in the safety net of millions of Floridians. As speaker, I am committed to ensuring that the existing safety net is there for those who are in need. However, I oppose Medicaid expansion because I do not believe the "take it or leave it," "all or nothing," inflexible approach of President Obama's Medicaid expansion strengthens the safety net; instead, this approach fosters more government dependency. According to estimates, 82 percent of the expansion population is not children, the disabled, or the elderly, but able-bodied adults. While the federal government promises to absorb the cost for the first several years, I am not confident it will be able to sustain that commitment in the long term. Given the track record of the federal government, which hasn't balanced a budget in years, I believe Florida will have to make hard choices that would potentially put future funding for our schools, public safety, and protection of our beaches and springs at risk and could mean increased taxes on hard-working Florida families.

Furthermore, the existing proposal ignores the stunning levels of fraud embedded in the Medicaid system, which experts estimate is more than $1 billion each year.

Equally as important, today's discussion ignores serious problems in the program's ability to provide quality care and also remain affordable. Florida doesn't have enough doctors to serve the expanded population, and quality of patient care will be put at risk. Medicaid's clinical outcomes are also concerning. According to a Journal of the National Cancer Institute study of Florida Medicaid patients, 6 percent were more likely to have prostate cancer when diagnosed than uninsured patients, 31 percent more likely to have late-stage breast cancer, and 81 percent more likely to have late-stage melanoma. Many studies suggest Medicaid patients routinely have worse outcomes when compared to those with private health insurance.

Although I personally oppose the expansion of Medicaid, I also recognize it's not enough to simply say no. The state has an obligation to investigate and pursue viable alternatives that will be in the best interest of all Floridians. And that's exactly what we're doing in the Florida House.

What's clear is that the inflexible Medicaid expansion plan that disregards Florida's responsibility to deal with our unique state needs and priorities, funded with inflated, unreliable federal spending is not the answer. The Florida House is focused on creating opportunities so that Floridians can receive a quality education, find a job and receive quality health care. By continuing to make this a priority while also working to strengthen the existing Medicaid program to ensure care for those who really need it, we can make sure Floridians have meaningful choices for health care regardless of their income or the challenges they face.

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Will Weatherford is a Republican from Wesley Chapel and speaker of the Florida House. He wrote this exclusively for the Tampa Bay Times.