TALLAHASSEE -- Republicans in the Florida House are trying to come up with a plan for the uninsured, something they believe would be better than expanding Medicaid.
But flirting with other options could jeopardize billions of federal dollars. And there are no guarantees the Legislature and Gov. Rick Scott will be able to agree on an alternative, or if it would produce better health outcomes for roughly 900,000 of the state’s poorest residents.
Rep. Richard Corcoran, chairman of the House committee that voted Monday against expanding Medicaid, has pledged to come up with a solution but admits he doesn’t have a plan or even a clear idea of what direction the state should go.
He likened it to the process of building a house. Right now, he is surveying the land and trying to find the right spot to lay the foundation.
“There’s a ton of ideas swirling around,” said Corcoran, a Trinity Republican. “It seems that I can’t talk to a member or senator who doesn’t have one.”
For many Republican lawmakers skeptical of Medicaid expansion, Arkansas Gov. Mike Beebe’s announcement over the weekend solidified their opposition. Beebe said the federal government had granted his state permission to use Medicaid expansion dollars to purchase private insurance policies for the uninsured on the health exchange.
It was a “game changer” that emboldened Corcoran and others to be innovative.
House seeking alternatives
Last month, Scott came out in favor of Medicaid expansion and he has not wavered. The Florida Senate has indicated it would go along with the governor’s proposal to accept federal dollars to expand Medicaid at least for the first three years when 100 percent of the costs are covered.
That puts pressure on the House to provide an alternative. But senators have started doing research, too.
“As you know this is uncharted territory, and we are still trying to understand what options are available,” said Katie Betta, a spokeswoman for Senate President Don Gaetz, via email. “Most recently, we have been reviewing and trying to learn more about the reported flexibility provided to states like Indiana and Arkansas.”
Lawmakers are both intrigued and a bit worried about the flexibility granted to Arkansas. Policies on health exchanges cost more than Medicaid — an average of $9,000 compared to $6,000 — and the costs both to the state and federal government for the Arkansas plan could inflate current estimates. Arkansas hasn’t finalized its proposal, which requires approval from the U.S. Department of Health and Human Services.
Indiana lawmakers have said they won’t expand Medicaid unless the federal government allows them to use their own health savings account-based “Healthy Indiana Plan.” In Iowa, Gov. Terry Branstad has floated the idea of beefing up the state’s low-benefit safety net program called IowaCare.
Corcoran is open to just about anything, as long as it’s not Medicaid. He believes people would be better served by obtaining insurance on the private market.
He doesn’t think the potential loss of federal dollars should be the deciding factor in how Florida proceeds. If lawmakers come up with a program that is affordable in the long run and doesn’t overtax existing resources he would agree to it even if that means Florida forfeits that money, he said Wednesday.