The House’s refusal to join the Senate in expanding access to Medicaid for hundreds of thousands of Floridians last Friday puts an end to the debate for this year, but it does nothing to deal with the critical healthcare problems facing the state.
Instead of challenging the federal government to work with Florida by signing off on an imaginative Senate-passed proposal that included a work requirement, lawmakers in the House took the easy way out and voted No by a margin of 72-41.
Among other things, they said the federal government would never accept the innovative Florida plan crafted by the upper chamber under the leadership of Senate President Andy Gardiner. The claim is repeated by House Speaker Steve Crisafulli in an opinion article on today’s Other Views page.
With all due respect to Speaker Crisafulli, how would anyone know unless they asked? The feds have been willing to consider modifications in the federal plan on other occasions. Moreover, had legislators approved the measure — and been able to convince a reluctant Gov. Rick Scott to go along — the federal government would have been obliged to at least consider it, and to face the serious political consequences of denying Medicaid expansion to the third-largest state in the country.
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As it is, we’ll never know. But we do know this: At least 600,000 low-income working Floridians, and probably up to 850,000 or more, remain without medical insurance and have to rely on emergency care subsidized by taxpayers at the local level. This is the worst way to provide healthcare, and the most expensive.
Among the other dubious claims made in support of rejecting expansion is that, in the words of Rep. Jason Brodeur, R-Sanford, it creates a “permanent dependency” on handouts for “able-bodied childless adults.” This is a cruel dismissal of the pain and desperation of hundreds of thousands of Floridians trapped in low-paying or part-time jobs who have to choose between buying food or buying insurance. There is no valid reason to deny them the lifeline that Medicaid expansion represents.
The bill passed by the Senate was not perfect, as many state representatives pointed out. But yet no one accepted the Senate’s invitation to draft amendments to improve the measure, which speaks volumes about the House’s stubborn unwillingness to consider improving the status quo.
And even though Obamacare has been spectacularly successful in Miami-Dade County — nearly 100 percent of those eligible signed up in some enrollment ZIP codes — every Republican state representative in the county who was present voted against the Senate healthcare expansion plan, except for Rep. Holly Raschein, of Key West, whose district includes part of South Dade. Shame on them.
The issue now becomes how to put together a healthcare budget for the state with limited taxpayer dollars to compensate for lost revenue from the federal government. So many figures with dollar signs have been bandied about in the Legislature and elsewhere that it’s next to impossible to know (1) how much federal funding will be available; (2) how much the state will be able to provide; and (3) how the money will be distributed around the state.
But we know this: Hundreds of millions of dollars that could have been used for education, roads, the environment and countless other priorities will now be dedicated to fill the gap created by the failure to approve Medicaid expansion. It’s Flori-duh all over again.