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Another voice: Florida needs Medicaid expansion

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 By Diane Garte

On Jan. 1, 2014, millions of Americans will become eligible for health insurance coverage under Medicaid; but none of them will be Floridians.  The Medicaid Expansion provides health insurance coverage for Americans under age 65 who have incomes less than 133 percent of the Federal Poverty Level.  If we put our minds to it, I’m sure we can all think of many families and individuals in our own neighborhoods and churches, who would fall below these thresholds.

It is estimated that about 1.2 million Floridians are uninsured and the almost 1 million of those would qualify for care under the Medicaid expansion.  Gov. Rick Scott supports Florida taking the Medicaid money, but has not been very active in gaining support from the Florida House and Senate.

Former Gov. Charlie Christ in a Nov. 6 interview with MSNBC's Chris Matthews said:  ‘Gov. Scott came out — free money. . . And he said that he was for it for about 30 seconds. Then he didn't lift a finger to make it happen. What did that do to my fellow Floridians? About a million of them will not get health care because he didn't try harder to get this thing done, was not effective in getting it done. And what does that mean? That means that people who are already sick and need to get health care are not going to get it so they will get sicker or they will die. It`s unconscionable that somebody would be that callous and that heartless.'

Florida’s legislators argue that the Medicaid expansion is too restrictive, yet the federal waiver program allows individual states to craft their own expansion program.  John Romano of the Tampa Bay Times on Dec. 7 wrote:  ‘State Sen. Joe Negron, R-Stuart, crafted a plan that would accept Medicaid funds to be used to purchase private insurance plans for low-income Floridians.   Arkansas had a similar plan with the blessing of the federal government.

“This completely eliminated all the squawking about inferior Medicaid coverage, it kept Florida from losing $51 billion in federal funds, it meant all kinds of high-paying jobs in the medical field and, best of all, it provided health coverage for an additional 1 million Floridians.

“The Florida Senate approved the plan in a 38-1 bipartisan vote.  (Florida House Speaker Will) Weatherford and the House killed it.”

What the House approved, and the Senate has chosen not to bring up for vote, is legislation which expands Florida’s Health Choices Plus to include more disabled people and those with dependent children.  This does nothing for low income Floridians who are not disabled and do not have dependent children, who remain one hospitalization away from bankruptcy.  

And there is no federal funding to support this program, so it, again, just says “no” to $51 billion.

Think of the older worker who is laid off through no fault of his own and cannot find another job at anything like their prior rate of pay, 10 years too young for Medicare and too old for the job market. 

Donna Shalala, president of the University of Miami and former secretary of health and human services, is optimistic and said, “When people say to me: Is Florida ever going to come around? 

My answer is yes, because a billion dollars is on the table and the stakeholders are big contributors to the Republicans – to the party. They understand that it will be a major economic investment in the state and they are just trying to figure out a way around the ideology in the conversations that are going on,” 

Patrick Geraghty, president and chief executive of  Florida Blue, said, “We believe strongly that we ought to be taking that funding. The money should be used to support change and innovation in healthcare systems.  For our state it's $51 billion over 10 years. That's a lot of investment in transformation.”  If the state does not take federal Medicaid funding, it will be a serious financial blow to many of the state’s hospitals.

I have been to enough Board of County Commissioners meetings to know that Levy County will pursue any federal funds available to support the effective management of the county, as it should.  Here’s a program that could provide health insurance to maybe 50 percent of Levy County’s under 65 population, and we can’t say yes to it because the state representatives have said no!?!  

I spoke with our state Rep. Charlie Stone about the Medicaid expansion. He said the federal government could not be trusted to pay 100 percent of the expansion costs for three years and claims there is no provision for funding beyond three years.

In fact, the provision is three years at full federal funding and then diminishing federal responsibility down to 90 percent federal responsibility where it will remain.  He cited the example of a 30-year-old able bodied man earning $15,000. per year (40 hours per week at minimum wage  as not deserving health care.

Wow. Sad enough that a 30-year-old is working for minimum wage; sadder still he has no means to obtain basic medical care. He asked if I thought people were entitled to healthcare and I said yes, I thought they were, in the interest of the commonwealh, just like they are entitled to an education.  

Stone said he did not feel people were entitled to healthcare, or public education either for that matter. 

At that point, I felt we had nothing left to discuss.  I didn’t mention the Florida Constitution entitling every Floridian to an education. 

Many states with Republican governors have refused the Medicaid Expansion, but some, like Michigan Gov. Rick Snyder (R) have signed on.  "This is about the health of fellow Michiganders," said Snyder in September.

 "The right answer is not to talk about politics, but to talk about our family of 10 million people." 

I would like to hear some of that kind of talk from our Florida leadership. When you take the politics out, it’s a ”no- brainer.”