In elderly-heavy Florida, the Medicare cuts could total about $60 billion over a decade, and the charity-care reductions an additional $2 billion. Another reduction outside of Obamacare, the so-called sequestration, could remove $10 billion.
So thats about $72 billion that could be removed from hospitals and healthcare providers in Florida. In other words, money that could otherwise be injected into the economy.
And that could affect employment in Florida. Tripp Umbach, a consulting company, estimated the sequester cuts could cost Florida 35,827 Medicare-related jobs next year, making Florida the nations second-biggest loser behind California.
But taking more Medicaid money under the guise of job-creation directly undercuts an already embattled conservative talking point: Government spending doesnt create jobs.
It does. It even creates the jobs of politicians and helps fund all the special interests who receive public money and then plow a portion of it back into politicians campaign coffers.
And with a budget that could weigh in at $74 billion and could employ almost 115,000 people next year, thats a lot.
Almost 32 percent of the current state budget is composed of federal money. So its not like Florida is going it alone anyway. Still, federal debt is a problem in the long term, and Florida lawmakers are rightly wary of taking free federal money.
The last time Republicans made a show of balking at federal money, in 2009, Obamas stimulus was passed. Then, as now, the Florida House passed a budget that refused the money.
Then-Gov. Charlie Crist and the GOP-led Senate took the cash. The House ultimately buckled, raising taxes by $2.2 billion along the way.
None of the horror stories of how the federal cash would make Floridas budget or the nations economy worse materialized.
But it made Crists political fortunes worse. Marco Rubio used Obamas stimulus to chase the governor out of the GOP; Rubio went on to become a U.S. senator, where hes working on an issue dear to Hispanics, immigration reform.
Crists successor, Scott, railed against the stimulus and Obamacare that year, but then signed a budget stuffed with stimulus money. After spending his personal money and campaign fighting Obamacare, Scott threw in the towel, saying Obamacares the law of the land.
Another once-fierce critic of entitlements and government spending, former congressman and past Florida House Speaker Tom Feeney, joined Scott in calling for Medicaid expansion.
Feeney is now the head of AIF, which took the Medicaid poll cited above, and his group estimates that expanding Medicaid would soften the blow or eliminate a maximum $1.3 billion in annual Obamacare business tax penalties for states that dont insure enough people.
But House Speaker Will Weatherford is still saying no. He and House leaders have long been concerned with the growth of Medicaid, which consumes ever-bigger portions of the state budget.
But in his first session as speaker this spring, Weatherford unknowingly praised a Medicaid-related program called Medically Needy, which helps catastrophically sick people who cant pay astronomical medical bills. His parents used Medically Needy money to pay the costs of cancer treatment for his younger brother, who died in 1995.
Last week, the federal government informed the state that it would essentially pick up the states entire share of the Medically Needy bill. That would save the state treasury about $436 million next budget year.
The saving is so great (at least $4.5 billion over a decade) that the state could sock away at least $1 billion through 2023 even if it continued with Medicaid expansion after three years, at which point Florida would have to kick in an ever-increasing share of state tax dollars.
If the state opted to stick only with Medicaid expansion for three years, the treasury would save at least $1.3 billion over that time.
Thats money that could be used to pay for other goodies: tax cuts, hometown spending, education, even healthcare.
So lets review: Taking the Medicaid money (at least for three years) would help people find insurance, shield hospitals from cuts, help the budget, help the economy, help businesses, help people like Weatherfords own family and perhaps help the GOP continue to attract Hispanic voters and anyone else who otherwise would think that Republicans dont care.
But if the House GOP gets its way, the rap on their party could be that Republicans care mostly about hating on Obama.