Published: Tuesday, April 28, 2015
It isn't complicated but has been made so by ideologues with power. The state has more than 800,000 people who are uninsured because they do not qualify for Medicaid or cannot afford insurance. The federal government has a contract with Florida, as with other states, to provide what is known as Low Income Pool funds to pay for hospital charity care when the poor go to an emergency room.
As part of the Affordable Care Act, the Obama administration told states the LIP money would be going away and urged them to replace it with a Medicaid expansion plan. So far 28 states have done so. The idea is it is more efficient medically and economically to provide regular health care to the poor somewhere besides a hospital emergency room.
The Florida Senate understood. So did Florida's major business groups, hospitals organizations and voters. A Senate Medicaid expansion plan calls for recipients to be working or in school and pay a small monthly premium. The plan, approved by Washington, would provide more care at less cost - saving an estimated $1.7 billion over five years - and create tens of thousands of jobs and pump tens of billions of dollars into Florida's economy over the next decade.
The Florida House leadership, however, has opted to play politics. Anything tied to Obamacare is anathema. From the start, Speaker Steve Crisafulli, R-Merritt island, and his lieutenants have stubbornly refused to even discuss Medicaid expansion. At all. Meanwhile, Gov. Rick Scott, who should be providing leadership toward compromise, is only exacerbating an already horrible situation. Not only is he opposing Medicaid expansion - after he was for it - he is suing the federal government for the LIP money, a case he is almost sure to lose on our dime. Scott says he does not trust the feds to provide the Medicaid expansion money - even though it is codified in the ACA law - but instead is demanding the feds keep the LIP money flowing. His stance is weak and hurts Florida and its residents.
But the damage does not stop there. Now the House and the Senate cannot complete a state budget - their singular constitutionally required task - by the end of the legislative session Friday. Their budgets are $4 billion apart, largely because of the health care impasse, and new funding for education, mental health care and new prison guards as well as some modest tax cuts are all at serious risk.
All so Scott, Crisafulli and Co. can make some ideologically driven political point that ultimately hurts real people.
Thank goodness for the adults in the Florida Senate. What Scott and the House membership are doing is endangering the health and well-being of Florida, which, contrary to the governor's economic hosannas, is still limping out of the recession.
Giving poor people access to health care while at the same time saving the state money and boosting its economy is good public policy.
Refusing to even discuss it is simply morally and fiscally indefensible.