The Legislature has been unfairly criticized for refusing to expand Medicaid when the blame for the growing mess in health care should be aimed squarely at the real culprit: the Patient Protection and Affordable Care Act (PPACA). This law’s employer health insurance mandate is the reason that business owners are faced with the predicament of either paying to provide health insurance for their employees or facing federal government fines.Business owners in Florida are scrambling to determine how they will deal with the implications of the PPACA mandate. They have turned to laying off workers, cutting back hours and paying more administrative costs just to figure out where their business must comply.As the Florida director of the National Federation of Independent Business said recently, “Small-business owners realize that there is no such thing as free money from the federal government, and any burden that comes as a result of Medicaid expansion will come from their bottom line and their ability to create jobs and grow their businesses.”It’s a law that’s not good for business here in Florida, and one whose implementation one of its principal authors — U.S. Sen. Max Baucus, D-Mont. — recently called “a train wreck.”Of course, there’s reason to believe that the law was meant to fail starting, conveniently, after last November’s election. Even the impending “train wreck” ironically may advance its advocates’ long-term goal of installing a single-payer system of socialized medicine. It’s a goal that some members of Congress such as former Congressman Barney Frank freely admitted.Meanwhile, Medicaid — as operated in most states — continues to be plagued by fraud, waste and abuse, even as it consumes an inordinate share of revenue that otherwise could fund worthy purposes such as improving education and safeguarding public safety.Moreover, a recent James Madison Institute study cited California research documenting that the uninsured there often receive better care than Medicaid patients. It’s a reminder that access to health insurance — especially such a deeply flawed form of it — is not the same as access to quality care.Yet even if one nonetheless supports adding thousands of patients to Medicaid’s rolls, this is certainly not the time to do so. The Agency for Health Care Administration, which oversees Florida’s Medicaid program, has its hands full right now.That’s because the Obama administration has finally approved Florida’s longstanding request for a statewide rollout of a managed-care approach that was originally outlined in a series of JMI studies and was successfully road-tested in recent years through a pilot project in five Florida counties.This approach, which a Wall Street Journal editorial praised the other day for improving patients’ care while also saving Florida’s taxpayers upwards of $1 billion a year, will be a good test of whether Medicaid programs can be reformed, and whether the cash-strapped federal government will keep its promise of covering all or most of the costs of expansion.Meanwhile, in prudently holding off on expansion, the 2013 Legislature did a huge favor for Floridians and thus deserves praise, not blame, for staving off pressures to expand a deeply flawed program. Lawmakers should continue to think outside the PPACA box when it comes to solutions for providing Floridians with improved access to quality care, and protecting current and future taxpayers.Read: http://www.tallahassee.com/article/20130524/OPINION05/305240008/Robert-McClure-Florida-right-not-expanding-Medicaid
