At long last, the state’s Republican leaders appear to have done the math and seem ready to hold what Sen. Don Gaetz, the Senate’s incoming president, called an “adult debate” with Democrats to bring Florida into compliance with the new federal health reform law.
And to think that it only took a year-long debate on Capitol Hill, a celebrated Act of Congress, a landmark Supreme Court decision and, finally, last week’s decisive national election to get Sen. Gaetz and his like-minded colleagues to see the light. It’s about time. Even Gov. Rick Scott, an outspoken foe of the Affordable Care Act, made what, for him, is a startling declaration: “Just saying ‘no’ is not an answer.”
After prolonged delay, it’s encouraging to see Gov. Scott throw in the towel, even if it was a hopeless cause from the get-go, and even if he remains skeptical about the law’s impact. All that Florida has garnered from two years-plus of denial and foot-dragging is lost federal funding and a very late start on getting with the program.
The issue is not whether Gov. Scott and his allies love “Obamacare,” or not, but whether they recognize that it’s the law of the land and compliance with its main provisions, including the mandate for everyone to obtain coverage, is not an option.
Beyond that, there’s a strong case to be made that in those instances where the state has some flexibility or alternatives, the best course is a full buy-in that protects more Floridians.
Case in point: Medicaid. The law offers states a major expansion of Medicaid, with Washington chipping in 100 percent of the cost for the first three years. After that, the Safety Net Hospital Alliance of Florida estimates that the state would have to pay up to 10 percent of the costs, or $1.7 billion over 10 years. The benefit would be two-fold: additional coverage for a million-plus Floridians and $27.9 billion from the federal government over 10 years .
A failure to opt into the Medicaid expansion would break down to a $4.5 billion loss for Miami-Dade during that time and $2.3 billion for Broward, according to the Safety Net analysis.
It’s easy to get confused by the numbers, so the bottom line bears repeating: Florida pitches in $1.7 billion and the feds pitch in $27.9 billion. Plus, more Floridians get covered who otherwise would have to seek emergency-room help — at public expense because of their indigent status.
Just as Medicare expanded healthcare coverage to seniors 65 and over who paid into the program through paycheck deductions, the new healthcare law promises to get more Americans insured, and thus, help reduce costs long-term.
If Florida doesn’t expand Medicaid for the poorest residents, safety-net hospitals such as Jackson Health System will be hit particularly hard.
It may already be too late for the state to set up its own public healthcare exchanges — a virtual marketplace for healthcare insurance open to all. This is unfortunate, but the federal government will set up exchanges for recalcitrant states if Republicans can’t get their act together.
“We’re not going to have a federal exchange,” said Rep. Will Weatherford, incoming House Speaker. This week was the original deadline for state action, but the federal government has offered some flexibility.
Mr. Weatherford will have to move fast. The state has lost funding for planning, but it can still salvage a good deal for Florida. The election is over. Time to end the political posturing.