George Gibbs Center for Economic Prosperity

The Flor⁠i⁠da Cour⁠i⁠er: Flor⁠i⁠da won’⁠t⁠ use money for ‘Obamacare’

By: The James Madison Institute / 2013

As the Florida Legislature’s latest session came to a close, Democrats renewed a call for a special session to expand health care coverage to cover more uninsured Floridians.Legislators adjourned last week without passing legislation that had been filed that would have either used federal money to extend coverage to more than a million people or used state money for a smaller subsidy.Billions to Florida
Under ‘Obamacare’ – the 2010 Affordable Care Act – the federal government promised to pay all of the Medicaid expansion costs during the first three years and the vast bulk after that. Obamacare would send more than $50 billion to Florida over the next decade.“By blocking passage this session of a plan that would dramatically help 1.2 million of Florida’s low-income and working families, many Floridians are disappointed and will continue, despite the session’s end, to expect the governor and Legislature to approve a bipartisan health coverage expansion compromise that relies upon available federal funds,” said House Democratic Leader Perry Thurston.He called on Gov. Rick Scott to call lawmakers back to Tallahassee “at the earliest convenience to pass a bipartisan health coverage expansion plan for Florida’s working families.”Scott now onboard
In February, Scott announced that he would support a Medicaid expansion. It was a dramatic turnabout, after Scott had waged a three-year-long political and legal battle against the federal health care law.Republicans, who were in the majority in both the state House and the Senate this year, made it clear they would not approve the Medicaid expansion. Both came up with different proposals to meet the health care requirements.The Senate wanted to use millions of dollars in federal money to create a new system for helping people get private coverage. The House wanted to reject federal dollars, but create a subsidy using state money for people to buy insurance.The Senate architect of the health care effort, Sen. Joe Negron, said that there’s no way any sort of compromise on the issue would emerge. “The chasm between the competing visions is too wide to overcome,”  he said.Negron described his plan as an “entrepreneurial approach” that would help people get health insurance. Though the plan would rely mostly on federal funding, Negron tried to reinforce that it is not an expansion of Medicaid, which has long been maligned by Republicans in both chambers.“Nothing in this bill expands Medicaid,” Negron said. “We don’t want to expand Medicaid.”Negron’s plan, which was backed by Scott, would use the Florida Healthy Kids Corp. as the vehicle for offering health insurance to people whose incomes are up to 138 percent of the federal poverty level. Florida Healthy Kids Corp. has long run the KidCare program, which offers heavily subsidized private insurance to children from low- and moderate-income families.Senate rejected
House members voted 74-45 to reject the Senate proposal, which was offered as an amendment to the House bill. Rep. Mike Fasano, a New Port Richey Republican who spearheaded the amendment, was the only GOP member to cross party lines and support it. All Democrats voted for the amendment.The vote came after about four hours of debate, with Democrats saying the Senate plan would provide needed health coverage to the working poor and Republicans saying the state shouldn’t rely on the debt-laden federal government to pay for expanded care.War on ‘Obamacare’
Democrats repeatedly said the House bill was ideologically motivated. The Senate proposal would offer coverage to roughly 1 million people, who were described by Rep. Jose Javier Rodriguez, D-Miami, as “casualties” of a broader battle.“The war on Obamacare is really what this comes down to,” Rodriguez said.Fasano implored his fellow Republicans to vote for the amendment, asking them to not “follow the script.”“Follow your heart today – follow your heart, and support this amendment,” Fasano said.Stuck with costs?
But other Republicans said the Senate plan would be akin to expanding Medicaid, which the GOP has long criticized for spiraling costs. Also, they repeatedly pointed to the federal government’s budget problems and raised questions about the long-term financing of the Senate plan.“Make a stand for your state, because this is not (about) ideology,’’ said House Health Care Appropriations Chairman Matt Hudson, R-Naples. “This is practicality.”More broadly, however, Republicans focused heavily on the Senate plan’s reliance on federal funding. Some lawmakers said Washington would have to use borrowed money to pay for a health expansion, while others raised concerns that Florida ultimately could be forced to swallow costs for the coverage.“What happens when we are forced to pick up a tab that we cannot afford?” asked Rep. Jason Brodeur, R-Sanford.Political fallout
Democrats have seized on the differences between Scott and the GOP-controlled Legislature to push back against the idea that Scott had a successful session.“The nation’s most unpopular governor attempted to use the 2013 legislative session as an Extreme Makeover: Political Edition. … Rick Scott knows he’s in trouble, and voters see through his electioneering about-face,” said Max Steele, a spokesman for the Florida Democratic Party.“Despite ample opportunities to pass a bipartisan health care solution that enjoys the backing of Republican Governor Rick Scott and the Florida Senate, House Republican leadership dropped the ball,’’ Thurston said.But not everyone was unhappy that a Medicaid expansion and the Senate health proposal failed. The conservative James Madison Institute issued a statement night pointing to potential problems with the Affordable Care Act and praising the House for not getting pressured into a “rash decision.”“In this case, taking no action instead of the wrong action was a wise decision by Florida’s leadership,’’ Bob McClure, president and CEO of the institute, said in the statement. “Expanding a badly flawed program such as Medicaid – which already consumes an inordinate share of the state budget – would not even necessarily benefit those whom it’s intended to help.”Scott could call lawmakers back for a special session on the issue. Negron said whether that will happen or whether the effort will wait until next year was up to legislative leaders and the governor. He thinks it is “improbable” that lawmakers would return to Tallahassee for a special session to address the issue.