Medicaid expansion: It’s on the House, now

Florida Legislature is back in session and on Friday the House will have a critical vote on Medicaid expansion for Florida.
Florida Legislature is back in session and on Friday the House will have a critical vote on Medicaid expansion for Florida. ASSOCIATED PRESS

The case for expanding Medicaid to serve an additional 850,000 uninsured people in Florida has strengthened during the first four days of the Legislature’s special session. Unfortunately, that may not make a difference when the House votes on the issue on Friday.

First came the disclosure that 1.3 million individuals in Florida could lose their health insurance subsidies if the Supreme Court rules that people in states without an insurance exchange don’t qualify. That makes creating a state exchange even more imperative.

Then, on Thursday, the Obama administration provided updated data showing how the Sunshine State would gain by opening eligibility for the government healthcare program to nearly all low-income adults.

If the 22 states that have not yet expanded Medicaid did so, according to a report from the Council of Economic Advisers, 5,200 deaths would be avoided each year. In Florida, the report estimates, 900 fewer people would die each year once coverage was fully in effect.

This shouldn’t come as a surprise: Provide more health insurance, reduce the number of deaths. That seems obvious and logical. But as we have also seen in the special session so far, and in the regular session that preceded it, the debate over Medicaid expansion has little to do with logic and facts, and everything to do with politics.

The most glaring display came on Tuesday, when months of frustration over healthcare talks came to a head in a Senate committee hearing where lawmakers berated the governor’s Medicaid chief for playing politics, and then subjected him to withering criticism over his lack of “quantitative analysis” of their bill.

Justin Senior, Medicaid director of the Agency for Health Care Administration, had told a House panel one day earlier that only “a small sliver” of the 800,000 uninsured in Florida would be covered because there would not be enough participants who could afford to pay premiums and meet the Senate’s work requirements.

That contradicted the testimony of the Legislature’s chief economist, Amy Baker, whose analysis showed that the Senate plan would cover as many as 650,000 of the uninsured and save the state $1.1 billion over 10 years. Her analysis was based on data obtained by the Florida census bureau, the Florida Office of Insurance Regulation and other sources. Essentially, she said, the savings would come because drawing down federal money to care for a needy population means the state will have to use less of its own money.

Mr. Senior was properly taken to the woodshed by the Senate because he had failed to offer his faulty analysis to the upper chamber, but was glad to share it with the House, where it received a warmer welcome because it tallied with their political opposition to expanding a program connected to Obamacare. “Was your copy machine not working?” one senator asked him, sarcastically.

Throughout the process, the Senate has listened to House critics of their original plan and has amended it twice this week, each time making it more palatable to conservative members of the Legislature, particularly in the House. Sadly, however, the House has not done likewise, failing to offer new ideas or to compromise.

On Friday, when the House is slated to vote on the Senate-passed plan. the representatives, for once, should realize that doing nothing is not an acceptable option for the people of Florida because illness and death have no political party.