The Florida Senate has drawn a new road map for House Republicans to get to yes on accepting Medicaid expansion money. Tuesday's proposed revisions to a bipartisan proposal to use the federal money to help pay for private coverage for low-income Floridians answer their strongest objections and should lower the demagoguery in next week's special legislative session. House leaders ought to be able to claim credit for forcing the adjustments and join their Republican colleagues in the Senate to embrace a proposal that is fiscally responsible and lets everyone claim victory.
The Senate's changes are aimed at three main arguments that House Republicans such as Appropriations Committee Chairman Richard Corcoran of Land O'Lakes use to fight the Medicaid expansion effort. First, they call Medicaid a failed program even though Republicans transformed it into a privately run managed care system. The Senate's proposal called for using the expansion money to place uninsured Floridians into those managed care programs for the last six months of this year until other private coverage options were available. The solution: The revised Senate plan would skip that interim coverage so that the uninsured would sign up for private plans starting in January, including plans on the federal exchange.
Second, House Republicans often suggest subsidized health coverage is a handout to the jobless who aren't looking for work, or to those who are working but are not working hard enough at finding a better job with health coverage. More than half of the 800,000 of the uninsured Floridians who would be covered by Medicaid expansion money are working in important sectors such as sales and construction, but that detail gets lost. The solution: The revised Senate plan, which already includes minimum requirements for looking for work, pursuing an education, or working, requires those looking for work to register with CareerSource Florida, which helps match workers with employers.
Third, House Republicans argue that the federal government cannot be trusted to follow through on public policy or to come through with promised money. Florida already counts on federal money for roughly one-third of its state budget, and the Senate plan already makes clear the state would cancel the plan if Washington ever delivered less money than promised. The solution: The revised plan also would prevent the state from approving any agreement with the federal government that varies substantially from what the Legislature approves.
At this point, the governor is irrelevant. It is the Legislature that has the constitutional authority to write a state budget, and the most responsible approach is to accept the Medicaid expansion money. The Senate has a bipartisan proposal that is in the best interests of the state, and it has made significant adjustments to address the concerns of House Republicans. There is a path now for everyone to win, from lawmakers from both political parties to Floridians who care nothing about politics and only want to be able to afford to see a doctor.