Miami Herald | EDITORIAL

Florida’s Medicaid debacle requires special session of the Legislature

From our It’s Worse Than You Think File: Not only does Florida refuse to take federal funds to expand Medicaid — spurning $51 billion over the next decade — but it now turns out that it also trails nearly every other state when it comes to accepting federal grants from Washington for healthcare reform.

A report from Health News Florida says state agencies usually refuse to compete for grants, which other states eagerly snatch up. Even worse: Some agencies have on occasion won grants from the feds — and then given the money back! One recent instance involved a $2.3 million grant for a toll-free consumer health information line, which a state agency won but then decided not to take.

It defies logic and common sense for any state to act against the interests of its own residents in this way, particularly in Florida. The state consistently ranks near the bottom in health statistics and has one of the largest medically needy populations in the country, but that apparently counts little in the face of ideological opposition to the healthcare reform law that opponents in Tallahassee scornfully label “Obamacare.”

The refusal to accept federal grants tied to ACA is part and parcel of this anti-Washington political strategy. But as federal officials publicly declared last week, it’s not too late for Florida to accept Medicaid expansion, and as the deadline for full implementation of ACA draws near, the case for acceptance becomes stronger.

Gov. Rick Scott came out in favor of Medicaid expansion after winning federal permision for a special plan to let Floridians obtain insurance through a state-subsidized system. But then Mr. Scottt failed to lift a finger to support this action during the legislative session after the House of Representatives under Speaker Will Weatherford signaled that it would reject the idea as a matter of “conservative” principle.

The expansion plan died — and with it the hopes of 1 million or more people in Florida who will be left without coverage.

But that must not be the end of the discussion.

Patrick J. Geraghty, president of Florida Blue, the state’s biggest private health insurer, points out that the mandated changes in the fee system will produce an improved and more efficient healthcare system, but hospitals and other health providers have to adapt to a new payment system. This is no time to starve the state’s healthcare system of dollars, he told Herald Editorial Board last week.

The business sector will feel the impact of the failure to fund Medicaid expansion because its absence will oblige employers to pick up some of the costs, and it will add to their tax burden. The costs of emergency care for the poor will continue to be passed on to the insured and to taxpayers, including businesses.

Accepting federal Medicaid dollars would reduce the number of uninsured and the amount of uncompensated care administered at hospitals. That’s why both of the state’s major business groups, The Florida Chamber of Commerce and Associated Industries of Florida, support Medicaid expansion.

The money the state rejects came from our taxpayers to begin with. Sending it back short-changes Florida’s residents, denies money to its hospitals and denies the state the chance to gain about 120,000 private sector jobs those funds would create.

As Brian E. Keeley, president of Baptist Hospital, points out on the Other Views page, all Floridians will pay a price for inaction because everyone is affected, one way or the other.

Gov. Scott paid lip service to the idea of Medicaid expansion, but he failed to expend any political capital on the effort. Now it’s time for him to show leadership on this issue. He should call a special session, even if there is no guarantee of victory, and tell the state’s lawmakers to put the welfare of the people of Florida above political ideology.

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