To Florida's legislative leaders, revive Medicaid expansion

March 12, 2013 

Instead of agreeing to accept an estimated $51 billion in federal money for Medicaid expansion over the next decade -- dollars paid by Floridians in taxes -- House and Senate committees have rejected pragmatism in the ideological war against the Patient Protection and Affordable Care Act.

On Tuesday, a Senate select committee rejected Gov. Rick Scott's proposal to accept expansion -- with one leading senator even suggesting the state abandon the entire Medicaid system. That ludicrous notion would put an enormous burden on taxpayers or bankrupt the state, or would the state abdicate society's duty to care for the weak and poor?

House Speaker Will Weatherford, R-Wesley Chapel, applauded last week's House committee vote to refrain from even writing legislation that would permit expansion.

The disclosure that Weatherford's family benefitted from a Medicaid program to cover the costly hospital bill for his brother's care makes his position all the more callous.

When Scott endorsed expansion, he recounted his family's poor roots but earned scorn from conservative Republicans even as other GOP governors also accepted the program's growth.

Once a fervent opponent of Obamacare, Scott concedes the act is now the law of the land and Medicaid expansion makes sense for Florida's economy and people. Weatherford and Senate President Don Gaetz should, too.

This vital safety net would add almost a million of Florida's poorest residents to the health care program, provide jobs and reduce uncompensated care costs on hospitals.

Economic studies predict an estimated 71,000 jobs will be created under expansion. The state's two major economic development organizations -- the Florida Chamber of Commerce and Associated Industries of Florida -- also favor Medicaid expansion, the chamber with conditions attached.

Concerns about the cost to the state and the federal government's commitment to expansion are reasonable, but the governor's proposal that acceptance be limited to three years counters that argument. The Affordable Care Act requires Washington to fully fund expansion during that time span, and then states gradually contribute until reaching the 10 percent mark in a decade.

As we have previously stated, Medicaid expansion will not only make for a healthier population but would also absorb the costs of some state health care programs, including those for safety-net hospitals, mental health and substance abuse programs and the Medically Needy service. A Georgetown University study estimated those savings at $300 million in 2014 and $100 million in 2020.

In blasting Medicaid expansion during his opening speech to this legislative session, Weatherford admitted that his uninsured family could not pay the medical expenses for his then 13-month-old brother, who passed away of cancer in 1995. But a safety net Medicaid program did, at more than $100,000. The speaker is in no position to demonize such health care.

Studies demonstrate that insured parents are better at meeting the health needs of their children than the uninsured. Opposition should also consider this conservative idea -- privatization. The governor only endorsed expansion after the federal government approved a conditional waiver granting Florida permission to privatize Medicaid statewide from its previous five-county pilot program.

The advantages of Medicaid expansion clearly outweigh the political and ideological factors against implementation.

Legislators should reconsider this unreasonable and unjust position and put expansion back into play.

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