Feds to Florida: Not too late for Medicaid expansion



Federal officials on Wednesday renewed calls for Florida lawmakers to accept an estimated $50 billion over the next 10 years to expand Medicaid, the joint state and federal health insurance program for the poor, to cover an additional one million Floridians who would otherwise remain uninsured even after Jan. 1 when healthcare reform begins in earnest.

Saying it’s not too late for Florida to accept federal funds available for Medicaid expansion, officials with the U.S. Department of Health and Human Services held a conference call with reporters to reiterate the economic and social benefits of expanding the healthcare safety net for the state’s poorest residents.

Under the proposal, the federal government would agree to pay 100 percent of the cost of expanding Medicaid in Florida, or an estimated $5 billion a year, from 2014 through 2016, and at least 90 percent thereafter.

Paul Dioguardi, director of intergovernmental and external affairs for HHS, said that Florida could expect to add about 120,000 private sector jobs to the economy and save the state an estimated $430 million in healthcare costs by accepting the funds.

“States can improve health, protect families from financial ruin, ensure doctors and hospitals get paid for the care they deliver, and boost the economy,’’ he said. “We’re still hopeful that Florida will take advantage of this generous offer.’’

Though Florida Gov. Rick Scott and other Republican lawmakers have been consistent in their statements that no special session will be called to reconsider Medicaid expansion, Dioguardi said he was encouraged by “the level of bipartisan support that we have seen from this’’ in Florida, as well breakthroughs in states where lawmakers relented on their earlier opposition to it, including Arizona, Arkansas and Iowa.

Medicaid expansion took center stage during this year’s legislative session.

The Senate supported a bi-partisan plan to take the federal money and let Floridians obtain insurance through a state-subsidized system. House Republicans insisted on an alternate plan to use $300 million in state money to buy basic coverage for 130,000 low-income residents.

In the end, the two chambers were unable to make a deal — and passed on billions of dollars in federal funds.

When the session ended in May, Democrats called on Scott to convene a special session on the issue. But with House Republicans unwilling to budge, the governor expressed little interest.

On Wednesday, a spokeswoman for Scott said the governor’s opinion hadn’t changed.

"We will not be calling a special session in Medicaid," Jackie Schutz said. The governor’s office declined to comment on the HHS press conference.

Sen. Joe Negron, a Stuart Republican and chair of the Senate committee on the Patient Protection and Affordable Care Act, said there was a “zero percent chance’’ of straight Medicaid expansion in Florida.

Negron also doubted a special session would be productive.

“It wasn’t possible back in April or May, and nothing has changed,’’ he said.

There is no deadline for Florida to accept the federal dollars, and state lawmakers could choose to opt out at any time. But the longer Florida lawmakers wait to accept the funds, the more they will lose when the clock starts ticking on Jan. 1.

If Florida lawmakers choose not to accept the federal funds for Medicaid expansion, Dioguardi said, that money would be used for other government programs, including expansion of Medicaid in other states. The money will not be used to pay down the federal deficit.

Dioguardi also pointed to an estimated 1.2 million people in Florida who would be left with no coverage at all because of assumptions in the healthcare law that states would expand Medicaid.

For instance, a family of four with an annual household income between $4,721 and $23,300 — or 20 to 90 percent of the Federal Poverty Level for 2013 — would be “left in the dark with no support,’’ Dioguardi said.

“So would all childless adults,’’ he added, “young people starting out, and older couples not eligible for Medicare.’’

For a family of four, the federal poverty level is $23,550 a year.

In Florida, an adult has to earn 19 percent or less of the federal poverty level and have a dependent child in order to qualify for Medicaid.

Approximately 3.4 million people — or 18.4 percent of the state’s population — were enrolled in Florida’s Medicaid program in 2009, the most recent year for which information is available.

Of the approximately $14.9 billion spent on Florida’s Medicaid beneficiaries in 2009, about $10.1 billion or 67.5 percent was paid for in federal dollars, and the remaining $4.8 billion or 32.5 percent was paid for by the state.

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