Editorial: Math for accepting Medicaid only gets better

Published April 17, 2013

As the economy struggled, Florida deeply cut spending on public schools, higher education, land preservation, the courts and every other corner of discretionary spending. Now the state could save $430 million spent on a state health care program if legislators would agree to accept billions of federal dollars and expand Medicaid. But even those savings, which could be spent on other priorities, may not sway House Speaker Will Weatherford and other Republicans who refuse to accept federal Medicaid expansion money.

This latest wrinkle in the debate over whether Florida should expand Medicaid to adults making up to 138 percent of the federal poverty line adds to a powerful argument that Republican lawmakers refuse to consider. Florida spends $430 million annually in its Medically Needy program that helps low-income patients pay for expensive medical conditions. The state covers 42 percent of the cost for the program. But under the Affordable Care Act, the federal government would take responsibility for 100 percent of the costs of covering this population for the first three years and no less than 90 percent in later years.

State budget analysts didn't include the $430 million annual savings in their calculations because the impact of the Affordable Care Act was unclear. Since then, federal officials have confirmed that the patients under Florida's Medically Needy program would be eligible for coverage under Medicaid expansion and the generous level of federal funding.

Still, Weatherford and other Republican leaders haven't budged. The Wesley Chapel Republican continues to support a plan authored by Rep. Richard Corcoran, R-Land O' Lakes, that provides insufficient payments for a modest portion of poor adults to buy private health coverage. Florida Health Choices Plus would be paid for with state taxpayer dollars at an estimated cost of $237 million per year. The plan forgoes $51 billion in federal funding over 10 years that flows with Medicaid expansion, leaves hundreds of thousands of poor Floridians without health coverage and forces Florida taxpayers to continue paying $430 million annually for the state's Medically Needy program. The math does not add up.

Weatherford, R-Wesley Chapel, argues that the federal government cannot be trusted to hold up its part of the deal in the long run. But Floridians expect Washington to follow federal law and meet its commitments, just as it has on Social Security and Medicare. State taxpayers shouldn't have to watch the money they send to Washington go to other states to expand their medical safety nets and boost their economies.

Republicans in the state Senate and Gov. Rick Scott, while no fans of federal health care reform, have been willing to put their political differences aside to stand for what is best for the state. Sen. Joe Negron, R-Stuart, is proposing a reasonable alternative to Medicaid expansion that would use the federal funding to pay for private insurance for the poor. There were plenty of good reasons to support Negron's option before the Medically Needy savings were discovered. Now there are 430 million reasons more next year, and another 430 million a year after that, and another 430 million a year after that, and …