Florida’s legislators faced a critical moral decision as they began the 2013 legislative session. The question was would they engage in a “race to the bottom” in healthcare by refusing to take the federal funding for Medicaid expansion to almost one million low-income Floridians? Or would they take the high road of compassion and caring for real working people who are not merely numbers on a legislative budget spreadsheet?
I am disappointed the Republican-controlled Legislature took the low road by rejecting Medicaid expansion and the accompanying federal dollars that would have provided healthcare to one million more Floridians.
Florida did not have far to go in a “race to the bottom” in healthcare. The Sunshine State is already 50th in the ranking of uninsured adults (29.5 percent) and 48th in the ranking of uninsured children (11.9 percent).
The Legislative Estimating Conference determined that Florida would gain $51 billion in federal funds (these are our tax dollars) to expand Medicaid over the next 10 years. The expansion would cost the state $3.5 billion over the decade. In fact, several studies provide estimates that the Medicaid expansion would add more than $2 billion to the Florida economy annually and add over 55,000 new private sector jobs.
Research reports also indicate that expansion will save money in other areas of the budget such as support for safety net hospitals, mental health and substance abuse funding, and the Medically Needy program.
Rejecting the Medicaid expansion will have severe consequences for low-income Floridians, businesses, and hospitals. It means leaving 100 percent of the federal funding on the table to be sent to other states. This legislative decision affects real Floridians who need healthcare and live from paycheck to paycheck.
Without coverage, these are people who will end up in our hospital emergency rooms, resulting in increased health insurance costs for everyone. Florida’s hospitals have a high stake in this Legislative decision. Unique among all businesses in Florida, the hospitals have a social mission to care for all Floridians who come to their emergency rooms and may not turn them away.
Because the Affordable Care Act anticipated near universal coverage through Medicaid expansion, it included major cuts in subsidies to hospitals that serve a large number of uninsured patients and that provide a high level of uncompensated care. For Florida, that means at least a $1.2 billion reduction over 10 years. Exacerbating this threat, hospitals are facing additional cuts through implementation of Diagnosis-Related Groups; termination of the Low Income Pool program, which brings $1 billion annually to hospitals; and a 2 percent rate cut proposed in the governor’s budget recommendations!
Republican legislators have ignored the studies that indicate jobs will be brought to the healthcare sector, that small businesses will be able to avoid the mandate penalty, and that states accepting the federal funds for Medicaid expansion will have a competitive advantage. They also ignored the genuine human needs of Floridians.
Ironically, while millions of state dollars have been given to private corporations with little accountability under the name of “economic development,” the Legislature had a chance to invest in real economic development while it also invested in the lives of Floridians.
The legislative session has only started so it is not too late for the legislative leaders to realize the opportunity that they have missed and reverse their decision. If the Republican legislators truly believe in a “safety net” as they allege, then what they must do is clear: Vote “Yes” for Medicaid expansion.
Nan Rich, who served in the Florida Senate from 2004-2012, is a Democratic Party candidate for governor in 2014.