Florida League of Women Voters pushes for Medicaid expansion

A drive for Medicaid expansion grew Thursday with the non-partisan League of Women Voters of Florida — one of the state’s oldest political groups — calling on legislators to find a “unique and flexible Florida solution” to cover an estimated 750,000 uninsured people this year.

In a conference call, the League’s president, Deirdre Macnab, said the debate over Medicaid expansion will become more acute as many safety-net Florida hospitals face the loss of nearly $1.8 billion a year in federal funding. Florida is among 22 states that still have not chosen to expand Medicaid as called for in the Affordable Care Act.

Florida’s safety-net hospitals, which serve large numbers of lower-income and uninsured patients, cannot afford to lose those dollars, said Charlotte Cassel, an attorney with Florida Legal Services, a nonprofit legal advocate for the poor, which issued a report in November sounding an alarm over the loss of money so-called Low Income Pool and Disproportionate Share Hospital funds.

“We will face a serious crisis,” Cassel said. “We will not be able to provide care to some of our hardworking, low-income Floridians.”

One potential solution the report suggests: Expand eligibility for Medicaid as envisioned under the federal healthcare law to cover all adults with incomes below the Federal Poverty Level. By refusing, state legislators are foregoing as much as $50 billion over 10 years that could help the state’s safety-net hospitals recover some of the federal funding that is scheduled to end by June 30.

In Miami-Dade — the county with the largest number of low-income uninsured residents in the state — the loss of those federal funds will hit safety-net hospitals hard, costing them as much as $600 million a year.

According to Cassel, Miami-Dade’s primary safety-net hospital, Jackson Memorial, risks losing about $570 million.

Thursday’s announcement from the League of Women Voters of Florida joins a push by state business leaders, who have pitched two proposals since December urging Florida legislators to find an alternative “free market” Medicaid expansion plan that would be more palatable to Republican leaders.

One proposal includes a provision that would require Medicaid beneficiaries to pay a premium for their coverage, regardless of their income level.

Macnab said that refusing Medicaid expansion amounts to an 8 percent hidden tax on consumers. She cited data collected by the Florida Association of Hospitals that found insured Floridians are paying about $1,200 per year more than they should to cover the costs of caring for the uninsured.

When the federal funding ends, those costs are expected to increase.

“We are hopeful that the strong business presence ... will hopefully open a pinhole of light into something much more exciting,” Macnab said.

Still, on Thursday some state legislators remained opposed to expansion in advance of this year’s legislative session, which begins in March.

House Speaker Steve Crisafullisaid the House has no plans to discuss Medicaid expansion, but left the door slightly open.

“I am a never-say-never kind of guy,” Crisafulli said.

Miami Herald Staff Writer Kathleen McGrory contributed to this report.

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This story was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

This story was originally published January 29, 2015 at 6:17 PM with the headline "Florida League of Women Voters pushes for Medicaid expansion."