Lawmakers weigh alternatives to Medicaid expansion


Herald/Times Tallahassee Bureau

As the Florida Legislature weighs options for insuring the state’s low-income residents, House Speaker Will Weatherford, for the first time, indicated Tuesday he might be open to accepting federal money.

“You never say ‘never’ in this business, I’ve learned that,” Weatherford, R-Wesley Chapel, replied when asked about his willingness to accept some federal aid as part of a House alternative to Medicaid expansion.

This is one of the biggest issues the Legislature faces this session. If lawmakers expand Medicaid or come up with a way to provide insurance for roughly 1 million poor adults, the federal government will pay all of the costs for the first three years.

Democrats and Gov. Rick Scott support accepting federal dollars to expand Medicaid, but House and Senate Republican leaders are against it.

Two alternatives have been proposed in the Senate: one that would qualify for the federal funding and another that would not.

Weatherford has criticized Medicaid expansion as a one-size-fits-all program that Florida won’t be able to afford in the long run. He accused the federal government of bribing states by insisting on an all-or-nothing deal.

Weatherford this week said he would like a more limited scope, such as a plan that helps the disabled or adults with children. He continues to oppose providing health care coverage to all adults meeting income requirements.

“Whatever the plan needs to be, it’s got to be something that is flexible,” he said. “It gives the state of Florida the flexibility it needs, but also is sustainable.”

In the balance is roughly $55 billion in federal funding over the next decade.

The Senate’s most recent proposal would provide less coverage for the uninsured and passes up on the federal dollars. The Health Policy Committee agreed to introduce Sen. Aaron Bean’s bare-bones approach on Tuesday.

Bean, R-Fernandina Beach, argued that his plan may be the only way to get all three sides — the Senate, the House, and Gov. Scott — to reach agreement.

“Our challenge, senators, if we’re going to find something or if we’re going to move on something: It has to be something that we can all say 'yes’ to,” Bean said.

Sen. Joe Negron, R-Stuart, has proposed taking the federal dollars but using them for a state-based health insurance program, rather than Medicaid.

Bean wants to provide subsidies that would help to poor Floridians cover the cost of private health coverage. His plan would rely solely on state funding — about $15 million in the first year — which would cover about 60,000 people.

People in the plan would be required to pay at least $20 a month, as well as copayments for medical services. The state would contribute $10 a month to help participants afford health policies.

The number of people who would qualify in any given year would depend on how much money the state would allocate to the program, a fact that troubles Sen. Jeff Brandes, R-St. Petersburg.

“It would rely on appropriations year-to-year so that individuals could find themselves one year participating and qualifying for the program and in another year not qualifying for the program,” Brandes said.

Halfway through the 60-day legislative session, no single idea seems to have won over a majority of lawmakers.

That could spell trouble, Brandes says.

“I think it’s going to be really challenging to see anything come together with the few days left we have in session,” Brandes said. “We’ll see what happens between the House and Senate, but, for right now at least for me, I don’t see any real resolution before the end of session.”

Herald/Times staff writer Michael Van Sickler contributed to this report.

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