Health Care

Medicaid expansion in Florida would reduce uninsured, Zika risk, reports say

Expanding Medicaid coverage to nearly all low-income adults of working age would help Florida reduce the numbers of uninsured people in the state while lowering the risk of Zika infection among pregnant women, according to two reports released Tuesday.

The nonprofit Urban Institute, in a study funded by the Robert Wood Johnson Foundation, argues that adopting Medicaid expansion in 2017 would reduce Florida's uninsured population by about 877,000 people.

A second report, by the left-leaning Center for American Progress, produced a map showing that the risk of Zika infection, among an estimated 2 million pregnant women nationwide, is greatest in Southern states that did not expand Medicaid coverage, including Florida. The report said Florida has more than 270,000 expectant mothers who could be vulnerable to the disease, which is known to cause birth defects.

But opponents of Medicaid expansion say the costs of covering more people are often higher than states expect, which reduces spending for other priorities, such as education and transportation, and that the public health insurance program provides low value for taxpayers.

“Medicaid expansion is a bad choice for policy makers,” said Brian Blase, a senior researcher with the Mercatus Center at George Mason University in Virginia and a former analyst with the Senate Republican Policy Committee. “Both the costs per enrollee and the total program costs are much higher than expected.”

Medicaid expansion, as envisioned under the Affordable Care Act, has been a contentious issue in Florida, one of 19 states that has refused to accept the federal government’s offer to pay the entire cost of expanded coverage for the first three years and never less than 90 percent after that.

Even without Medicaid expansion, however, the Urban Institute concludes that nearly 7 million people have gained coverage in the 19 states that have refused to increase coverage under the public health insurance program, including more than 1.5 million Floridians who have signed up for coverage on the so-called Obamacare exchange this year.