The idea was to avoid dragging immigration politics into the health care debate. But while states can opt out of the Medicaid expansion, they cannot change the rules for non-U.S. citizens. As a result, some non-U.S. citizens will be better off.
Lawmakers in Florida are far from the only ones to have failed to reach a health care agreement. Nine other southern states have said they will not expand Medicaid coverage. Wyoming, South Dakota, Nebraska, Pennsylvania and Alaska also appear ready to reject federal health care assistance. Another dozen or so states are still weighing their options.
Leaders in many of those states say the 2010 law leaves little flexibility to pursue a plan that fits their needs.
In Florida’s case, House Republicans were particularly reticent to accept the federal funding or provide subsidized health care to single, childless adults. They came up with a plan of their own, relying on solely state money, that did neither.
Some Republican lawmakers went as far as to characterize childless adults as people who could get insurance, if only they weren’t so lazy. Rep. Matt Gaetz, R-Fort Walton Beach, said the group was too busy playing a Grand Theft Auto video game to get a job. His father, Senate President Don Gaetz, R-Niceville, said he had little concern “somebody who is an adult and chooses to sit on the couch.”
While the federal government has been willing to discuss how states provide health care, they have yet to budge on who is eligible. The health care law says that all people who make less than 138 percent of the federal poverty level — about $16,000 for a single person — should receive subsidized insurance coverage.
The plan offered by House Republicans purposely did not cover the 400,000 people who make between 100 and 138 percent of poverty, noting that they would be eligible to purchase insurance on exchanges.
Not said by lawmakers: the potential hit to businesses.
It’s unclear what will happen next. Senate leaders, who are willing to accept federal money, say they will continue to work on a compromise that House Republicans might stomach.
Gov. Rick Scott, meanwhile, could force lawmakers to return to Tallahassee for a special session. Or lawmakers could try again in 2014.
Karen Woodall, director of the left-leaning Florida Center for Economic and Fiscal Policy, believes the reaction of Florida businesses will push GOP lawmakers to get something done sooner than later.
“That gives me some comfort level that there will be a special session,” she said. “If it were just poor people getting health coverage, I don’t know if the state would ever act.”