TALLAHASSEE, Fla. (AP) — A key legislative panel on Monday voted against expanding Medicaid coverage to roughly 1 million more residents under the federal health overhaul, expressing fears that the federal government would ultimately back out of paying its share and leave the state on the hook for billions.
The vote was strictly partisan with House Republicans contending that the state's current safety net program — which costs about $21 billion a year to cover more than 3 million Floridians — is already broken and that adding more patients would only exacerbate problems. The federal government has offered to pay the full cost of Medicaid expansion for the first three years and 90 percent thereafter.
House Democratic Leader Perry Thurston of Plantation called it "morally reprehensible" that the House was rejecting Medicaid expansion.
"We are talking about people's lives," Thurston said.
House Speaker Will Weatherford, who hasn't been shy about his opposition to Medicaid expansion in recent weeks, said lawmakers can't count on the federal government to pay 100 percent of the cost for expansion.
"The facts show that healthcare costs will go up for many Floridians, while access to and quality of healthcare will go down," he said in a statement.
The decision sets up a clash with Gov. Rick Scott, who called Medicaid expansion a "compassionate" and "common sense" step to take to help Florida's large uninsured population. He proposed expanding the program for three years or as long as the federal government foots the entire bill. Scott could have an ally with the Florida Senate, which has not yet taken a final stance.
A Senate committee scheduled to vote on the issue Monday was postponed, with chairman Sen. Joe Negron saying he'd rather get it right than make a hasty decision. He also dismissed the idea of doctor shortages in the current Medicaid program, a common concern among Republicans, as a reason for not expanding the program, saying state lawmakers should be able to find workers if they want a service badly enough. But like the governor, Negron has repeatedly expressed concerns about costs.
Florida Democratic Party Executive Director Scott Arceneaux quickly pointed to the House's recommendation as a failure by Scott to "lead his own party" accusing House Republicans of putting "politics before the well-being of Floridians."
At a joint committee hearing with the Senate earlier Monday, a state economist ticked off a list of added costs brought by the federal health law, but stressed the benefit of insuring more residents would outweigh them.
Even though roughly 1 million residents would be eligible for coverage under Medicaid expansion, state economists estimate only about 463,000 would sign up next year if the state decides to expand the program. That number jumps to roughly 892,000 by 2020. More than 85 percent are childless adults.
The state's chief economist Amy Baker estimated it will cost the state $330 million in fiscal year 2020-21 and warned that finding skilled health care workers within the state to help care for the increase in newly insured patients is a chief concern.
The state will also spend about $101 million in 2013-2014 to cover patients who are currently eligible for Medicaid, but are not enrolled. The federal matching rate for that population is much less generous than the expansion group with the feds only paying about half of those costs.
Hospital executives have stressed they would be hit doubly hard if the state does not expand Medicaid because they would lose other federal funding streams that cover large numbers of uninsured patients since the law assumes those patients will have insurance through Medicaid expansion or through state online health exchanges. Florida officials have estimated the state would receive about $26 billion from the feds over the next decade and that expansion would create about 54,000 new jobs.
Rep. Richard Corcoran, R-Trinity, and chairman of the House select committee evaluating the overhaul, contended that the state should do something to ensure that uninsured Floridians get coverage as long as it is not in the Medicaid population.
But he acknowledged it may take a year in order to come up with an alternative plan.
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