Future of Medicaid expansion in hands of key GOP House members

After weeks of posturing and debate, the decision to expand Medicaid in Florida or accept $51 billion in federal healthcare money might rest with a moderate bloc of a dozen or so House Republicans.

And they’re not saying a lot, at least publicly.

While Senate Republicans appear willing to join Democrats in supporting a massive healthcare expansion, many House Republicans serving in moderate districts have yet to vocally embrace or reject federal assistance.

A union supporting healthcare expansion is targeting them with television ads in an attempt to influence their vote. But the group also is hearing from conservative Republicans, who oppose accepting the federal money.

A plan to take federal assistance requires 60 votes in the House, which would be a majority because one seat is vacant. That means House Democrats need 16 Republicans to join their 44-vote bloc.

Freshman Rep. Kathleen Peters, a moderate Republican from the beach town of South Pasadena, near St. Petersburg, feels like she’s on the campaign trail again, defending herself against negative attacks.

TV ads produced by SEIU Florida, a labor union, accuse Peters of “putting politics ahead of working families” in opposing Medicaid expansion.

The problem, Peters said, is that she hasn’t decided how she will vote.

“To be just filling the airwaves with tabloid sensationalism when we haven’t even taken a vote on that issue, to me, is shameful,” she said.

Peters is among a half-dozen GOP lawmakers being targeted in ads in Democratic-leaning districts, said SEIU Florida President Monica Russo. Russo said they were chosen because they are Republicans who should be most willing to accept federal money.

Peters’ district supported President Barack Obama in 2008 and 2012 and Democratic gubernatorial candidate Alex Sink in 2010.

Other targets include Reps. Manny Diaz Jr. and Erik Fresen in South Florida, Reps. Bill Hager and Gayle Harrell on the east coast and Rep. Ross Spano in Hillsborough County.

“I’ve got time yet to make a decision,” Peters said.

Rep. Holly Raschein, a freshman Republican from Key Largo, appears to have made up her mind.

While House leaders, including Speaker Will Weatherford, R-Wesley Chapel, want the state to reject federal assistance, Raschein’s constituents want the money, she said. They believe it could improve access to healthcare in the Florida Keys.

“I understand where leadership is coming from, not relying on D.C. for everything, and I completely get that argument,” Raschein said. “But it’s the law of the land, and we must move forward. [If] they’re not going to spend it on Florida; somebody else is going to get it.”

She would join Rep. Mike Fasano, R-New Port Richey, who has said he will try to force a floor vote on a plan to accept the federal money.

Florida “has the opportunity to help so many more . . . that have been suffering for so long,” Fasano said.

Other House Republicans representing moderate districts told the Herald/Times they had reservations about accepting the federal money or had not made up their minds.

Rep. Ed Hooper, R-Clearwater, said the growing national debt, which is nearing $17 trillion, makes him unsure about the government’s ability to meet its long-term financial commitments. He supports the House plan, which uses only state funds to provide basic coverage to 130,000 people. Federal money could cover 1 million people or more.

Along with House lawmakers in moderate districts, supporters of expanding Florida’s healthcare system are targeting Hispanic lawmakers.

Polls show that the healthcare law is popular among Hispanic voters. A January survey by the Florida Hospital Association found that 74 percent of Hispanics supported accepting federal funding, with 56 percent saying they felt strongly about the issue. A March poll by the business group Associated Industries of Florida found that 60 percent of Hispanics favored Medicaid expansion.

Speaking in both Spanish and English during a press conference last week, Rep. Victor Torres, D-Orlando, said Democratic lawmakers are “fighting for the Hispanic community, for the families, for the children” by insisting that the House accept the federal aid.

Torres stood alongside three other Hispanic House members, but no Republicans.

It is a different story in the Senate, where Joe Negron, R-Stuart, has drafted a plan that accepts federal dollars and has bipartisan support. Republican Sens. Rene Garcia of Hialeah and Anitere Flores of Miami voted in favor of the Senate proposal during last week ’s healthcare budget committee meeting.

The Legislature’s Hispanic caucus has met once this session, about a month ago. Torres said he brought up Medicaid expansion at the meeting, and urged the caucus to take a position.

“My concern at that time is we should lead the charge of the Medicaid expansion, Republicans as well as Democrats,” he said. “But they, at that time, felt that they were still waiting to see what was transpiring over here,” said Torres, motioning toward the Senate chambers.

Torres said he was not sure whether any Hispanic House Republican would break ranks. “I think it’s going to be, for them, a tough issue to side with us,” he said.

Rep. Manny Diaz Jr., the Hialeah Republican who is being targeted in television ads, said he did not want the state to rely on federal funds.

“Three years down the line, we don’t want to be in the position where we come back in this chamber and we’re in a position where we have to take something away because now we don’t have the money and the federal government has pulled out on us,” he said.

One thing that could cause a shift among House Republicans is a change of heart by Weatherford himself.

He has criticized the federal government’s all-or-nothing approach to Medicaid expansion — which requires expanding healthcare coverage to childless adults in Florida for the first time — but he has also signaled that he would accept some federal money for a more-limited program. A compromise like that would require the approval of the federal government.

Will it happen?

Like the vote count, it’s hard to gauge.

“I think that Speaker Weatherford is so far out there, has taken many of the Republican members so far out to opposing taking any federal dollars, that this late in the game it’s going to be difficult for them to come back to the middle, if you will, and accept either all or some of the federal dollars that are available to the state of Florida,” Fasano said.

Herald/Times staff writers Steve Bousquet, Katie Sanders and Toluse Olorunnipa contributed to this report.