Let’s be honest about Obamacare

Despite lawsuit against the federal government, Gov. Rick Scott met with the feds seeking a LIP extension, but was rebuffed.
Despite lawsuit against the federal government, Gov. Rick Scott met with the feds seeking a LIP extension, but was rebuffed. MIAMI HERALD

Given the hard feelings in the Legislature over the failure to complete a budget during this year’s regular session, we offer a modest hope for the upcoming special session: that lawmakers can engage in an honest discussion about Medicaid expansion and the Affordable Care Act.

They owe at least that much to the people of Florida. Until this year, the very mention of “Obamacare” ignited a knee-jerk rejection of the law among the Legislature’s Republican leaders. They refused to consider the benefits that federal law bestows on eligible citizens who need health insurance.

The result has been a callous denial of Medicaid services to 850,000 uncovered Floridians. This year, however, Senate President Andy Gardiner and his colleagues decided enough was enough. They crafted a Florida-specific Medicaid expansion proposal that contains free-market provisions and allows Florida to accept Medicaid expansion and up to $51 billion in federal dollars over 10 years.

But House Speaker Steve Crisafulli wouldn’t budge, or even bring the measure up for debate in the House. Mr. Crisafulli is entitled to his political objections against the law, but he’s not entitled to his own facts. So far, the explanations he’s offered don’t withstand scrutiny.

He told a radio interviewer last month that Floridians don’t want it — “Medicaid expansion isn’t necessarily a very popular issue on the street.” But PolitiFact Florida found polls showing that a majority of Floridians do indeed favor expansion. Most Florida Republicans don’t like it, but that is clearly not the same thing as a statewide popular majority. PolitiFact rated his statement “half true.”

Then there’s the phony allegation that the federal government surprised Florida by denying it money to support hospitals that help the indigent so as to “force” the state to accept Medicaid expansion. In fact, state officials were warned in no uncertain terms in April 2014 that the feds would not fund the current version of the Low Income Pool program — LIP — after one more year.

Even so, Gov. Rick Scott made a vain attempt last week to negotiate an extension of that program — with the federal agency that he had earlier sued! Not surprisingly, he failed. He had more than a year’s notice that this was coming down the pike and chose to ignore the impending crisis.

When all else fails, Medicaid expansion foes fall back on the argument that the federal health-insurance law is unworkable and too expensive. “It would be financed by mortgaging our children’s and grandchildren’s future,” Mr. Crisafulli wrote in an opinion article in these pages recently. In fact, a report earlier this year by the Congressional Budget Office — Congress’ impartial scorekeeper — offered a reality check: It said the Affordable Care Act has slowed the cost in health spending, and that the law’s cost from 2015 to 2019 would be 20 percent ($139 billion) less than earlier forecasts.

In addition, the program has delivered above-predicted sign-ups — especially in greater Miami — premiums below expectations and a sharp drop in the number of Americans lacking health insurance. By adopting Medicaid expansion, Florida could add nearly 1 million people to that number.

Without Medicaid expansion, the state will find it impossible to balance the budget unless lawmakers take money from other necessary programs to tide over their differences. But that’s not a smart approach, nor is it necessary, providing they can summon the will to set aside political calculations long enough to do what’s right for the people of Florida.