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Editorial: Avoid crisis and take Medicaid money

A top official from the federal agency that oversees Medicare and Medicaid ruffled Republican legislators and exposed a big hole in the governor’s proposed budget. That should prod lawmakers to drop their partisan opposition to the Affordable Care Act and accept billions in federal Medicaid expansion money to cover the uninsured and avoid a financial crisis for Tampa General and other hospitals.
A top official from the federal agency that oversees Medicare and Medicaid ruffled Republican legislators and exposed a big hole in the governor’s proposed budget. That should prod lawmakers to drop their partisan opposition to the Affordable Care Act and accept billions in federal Medicaid expansion money to cover the uninsured and avoid a financial crisis for Tampa General and other hospitals.
Published Feb. 11, 2015

Gov. Rick Scott should be the only one surprised that the Obama administration will not keep sending more than $1 billion to Florida to help cover hospital costs for the poor and uninsured. A top official from the federal agency that oversees Medicare and Medicaid merely confirmed it this week at an Orlando health care conference, ruffling Republican legislators and exposing a big hole in the governor's proposed budget. That should prod lawmakers to drop their partisan opposition to the Affordable Care Act and accept billions in federal Medicaid expansion money to cover the uninsured and avoid a financial crisis for Tampa General and other hospitals.

Florida already is on borrowed time, with the federal government agreeing last year to send $1.3 billion for just one more fiscal year that ends June 30. The money flows into the Low Income Pool, a $2 billion account where the federal money is matched with money from counties, hospital taxing districts and state agencies. The program was to end because the Affordable Care Act counted on states expanding Medicaid to cover many of the same patients. But Florida House Republicans stubbornly refuse to accept the Medicaid expansion money, and Scott blithely included the federal LIP money in his proposed budget for 2015-16 and assumed Washington would cave again.

Now it's up to the Legislature to be the responsible branch of government. There is a compelling moral argument that the state should accept the federal Medicaid expansion money to help provide health coverage for up to 1 million uninsured Floridians. Many of them make too much money to qualify for Medicaid now but too little to qualify for a federal subsidy to help pay for coverage on the federal exchange. Now the economic argument is even more pressing with the certain end of the LIP money. When that money disappears this summer, Tampa General stands to lose more than $85 million and BayCare, Tampa Bay's largest hospital group, expects to lose more than $77 million. How would Tampa Bay legislators return home and explain to their constituents why they refused to accept federal Medicaid money and let their hospitals face a financial debacle?

There is a ray of hope in Tallahassee that common sense will prevail. Senate President Andy Gardiner, R-Orlando, supports accepting the Medicaid expansion money. He told the Tampa Bay Times editorial board on Wednesday that a proposal by a broad coalition of businesses to use the federal money to help the uninsured buy private insurance will get a committee hearing the first week of the legislative session in March. Gardiner discounted the familiar argument by Republican House members that the federal government cannot be counted on to keep providing its share of the money, pointing out that 38 percent of the state budget is federal money for social services, transportation and other issues.

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Twenty-eight states have accepted the Medicaid expansion money, including 10 with Republican governors. Surely Florida does not want to be like Tennessee, where Republican lawmakers last week rejected taking the money after being pressured by Americans for Prosperity, the tea party group backed by the Koch brothers. The Florida Legislature should act in the best interests of Floridians — and listen to businesses, hospitals and voters who recognize that accepting the federal money and expanding health coverage makes sense.