Obamacare's odds of solving Manatee indigent health care crisis slim

April 17, 2013 

Manatee County voters will know well in advance of June 18 whether the state of Florida accepts federal assistance for health care for the poor. As of today, though, the chances are slim that Obamacare will pay the cost of that care in this state -- a major issue here with a referendum on a sales tax increase to pay for indigent care two months away.

When the U.S. Supreme Court struck down the mandatory Medicaid expansion provision of the Patient Protection and Affordable Care Act as unconstitutional, states had to decide whether to voluntarily join. But Florida's House continues to reject federal aid in a shortsighted ideological battle. A Republican-controlled committee voted Monday to create a state-subsidized plan instead.

But the legislation is too weak, providing state-subsidized health insurance to only 130,000 of the 1 million Floridians too poor to pay for coverage. The gap is too wide to help Manatee County much.

The state Senate offers a more pragmatic program by accepting the billions in federal aid to let those million residents purchase private health care insurance. With bipartisan support, Gov. Rick Scott's approval and hospital industry backing, this legislation is vastly superior to the House plan -- which will cost Florida taxpayers $237 million.

Florida cannot afford to reject $55 billion in federal aid over the next decade. No other part of the Affordable Care Act covers indigent care.

House Republicans are adamant in their opposition to Obamacare over fears the federal government will break its promise to pay 100 percent of Medicaid expansion for three years beginning Jan. 1, 2014, and 90 percent afterward.

With less than three weeks left in the legislative session, there's little indication the House will compromise on this issue and Florida could be left with no progress on health care for the poor.

There is a perception among some Manatee County voters that Obamacare will solve the community's looming problem paying for indigent care but there's the distinct possibility that will not be the case.

Last week, county commissioners approved the June 18 date for the special election on a half-cent sales tax increase -- from 6.5 percent to 7 percent.

The estimated $23 million in new revenue will be spent in two ways: about $9 million to partially reimburse hospitals for treatments for the poor and to cover the cost of proposed property tax reductions. The county will not receive a windfall of fresh revenue to spend on pet projects, as some residents suggest.

People owning property within the county's municipalities would get a 26 percent cut while those in unincorporated Manatee County would receive a 13 percent reduction.

City property owners would no longer be paying for sheriff's patrols, a fair plan since they do not receive that benefit.

Some voters also mistakenly think the sales tax increase will convince Manatee residents to shop elsewhere to save -- but Sarasota, Hillsborough and Pinellas counties already charge 7 percent, so the local economy is highly unlikely to suffer.

With the county's Health Care Fund on the verge of being drained, the sales tax increase will prevent the county from being forced to raise property taxes to cover indigent care. The status quo cannot be maintained.

Should Florida accept federal assistance before the referendum, Manatee County's commission has stated the sales tax increase could be rescinded.

Otherwise, voters will decide whether a sales tax increase and property tax relief are in their best interests. We find this is a reasonable way to solve the indigent care funding problem -- which the county cannot ignore or avoid.

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