Medicaid expansion for one million low-income adults in Florida may technically be dead, after committees in both the House and Senate voted to kill it. And yet, chances for an alternative plan that would accomplish the same goals are looking up.
On Wednesday, federal health officials signaled interest in seeing Florida’s alternative plan, which is still just a gleam in the eye of a powerful state senator, as soon as the state has something in writing.
And a report on how much it would cost the state to offer coverage to private plans to the newly insured estimated that it would cost 3 percent to 4 percent less than for the current Medicaid population.
Even House Speaker Will Weatherford, a vocal opponent of Medicaid expansion, moderated his tone somewhat in speaking to reporters this week.
“We’re very pleased the Senate … has taken off the table the idea of expanding Medicaid. Now the conversation has shifted from that to how do we make sure more Floridians have access to insurance? That’s a very worthy conversation to have," said Weatherford, R-Wesley Chapel.
"They’re talking about private sector ideas, innovative ideas ...that’s something the House is interested in talking about,” he said.
In an op-ed published Wednesday in the Tampa Bay Times, Weatherford wrote: “Although I personally oppose the expansion of Medicaid, I also recognize it’s not enough to simply say no. The state has an obligation to investigate and pursue viable alternatives that will be in the best interest of all Floridians. And that’s exactly what we’re doing in the Florida House.”
The not-Medicaid plan for those who would be newly covered is still being drafted and apparently doesn’t yet have a name. In describing it Monday, Sen. Joe Negron just called it the “Florida Plan.” Other senators called it the “Negron Plan."
The consultants’ report on which Negron based his savings forecast called it the “Medicaid Benchmark Plan for Potential Adult Medicaid Expansion.” That report was done before the Legislature banished the word "Medicaid."
Negron, chair of the Senate Select Committee on the Affordable Care Act, talked about the not-Medicaid plan on Monday as an alternative to expanding Medicaid the way the ACA describes. He said it wouldn’t be right to just leave the 1 million poorest of Florida’s 4 million uninsured without access to health care -- the confounding result if states vote no on the Medicaid expansion under ACA.
The committee followed his suggestion and voted 7-4 — along party lines, with Republicans in the majority — to turn it down. Headlines around the nation took that as a definite no.
But there were numerous reasons why that vote was instead a "maybe," apart from Negron’s stated angst about leaving hard-working poor people without access to health care. One is that leaving an estimated $51 billion over 10 years on the table wouldn’t play well with many Floridians. The law calls for 100 percent federal funding for the Medicaid expansion group for three years, and at least 90 percent thereafter.
Another reason the vote likely isn’t a definite no is that it would leave Republican Gov. Rick Scott, who voiced support for the Medicaid expansion, looking ineffectual as he heads into the 2014 re-election campaign.