Pros overwhelm cons in Medicaid expansion for Florida

February 13, 2013 

The state of Florida should accept Medicaid expansion under the Affordable Care Act as more evidence comes to light indicating the positives outweigh the negatives.

When Gov. Rick Scott unveiled his $74.2 billion state budget blueprint two weeks ago, he scrupulously avoided issuing an edict on Medicaid -- stating, "Today is not the day for that decision." Florida Senate President Don Gaetz and House Speaker Will Weatherford are forging ahead with committee hearings on the issue, with a decision expected early in the legislative session, which opens in early March.

In affirming ACA, the U.S. Supreme Court ruled states could opt out of the Medicaid provision. That would be a grievous mistake -- as more and more Republican governors are discovering in reversing earlier disdain. Last week the chief executives of Michigan and Ohio accepted the expansion. At that time, Michigan Gov. Rick Snyder stated, "This makes sense for the physical and fiscal health of Michigan."

The same applies to Florida. Here's why:


Currently, 3 million of the state's most poverty-stricken residents -- half of them children -- are covered by the federal-state Medicaid program. Under the expansion of coverage, an estimated 900,000 additional low-income families would be covered.

Greater access to medical and preventive care will improve Florida's physical health and steer patients away from more expensive emergency room care.

Since federal law requires hospitals to treat anyone who enters an emergency room, uninsured and poor patients create a financial burden on the institutions. Medicaid expansion would provide relief from that. Plus, people with health insurance would no longer indirectly cover those costs with higher premiums.


Florida spends about $21 billion on Medicaid. The governor decried expansion as far too expensive, citing a state study that claimed Florida's cost would be $26 billion over a decade. But the figure proved false -- and with a political foundation by assuming the federal government wouldn't fulfill ACA's commitments.

The governor's Agency for Health Care Administration then revised the estimate and put the 10-year cost at $3 billion. Even that is debatable.

The federal government will pay the entire cost for the first three years of expansion and then in 2017 states will pick up a small portion that will only reach 10 percent in 2020.

A new study outlines how Florida would actually save money over the decade. The Georgetown University report calculated savings from other state programs, such as the costs for safety-net hospitals, mental health and substance abuse programs, and the medically needy service.

Those savings amount to $300 million in 2014 and $100 million in 2020.


Should Florida prove foolish and reject expansion, the state would lose an estimated $26 billion in federal money over 10 years -- dollars that Floridians send to Washington in taxes. Instead, that money should return to the Sunshine state and be paid to hospitals, doctors and the health care community for vital insurance coverage to additional poor residents.

Medicaid expansion means jobs, too, with a new study commissioned by the Florida Hospital Association showing 56,000 new positions under ACA provisions.

Poll of Floridians

The FHA also sponsored a survey of Floridians and found a convincing majority -- 62 percent -- want the state to accept Medicaid expansion. Of those, 49 percent expressed strong support for the additional health insurance coverage for the poor.

The people have spoken. It's time to set aside ideology in favor of pragmatism.

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