Manatee County commission decides against lobbying for Medicaid expansion

skennedy@bradenton.comSeptember 11, 2013 

MANATEE -- Manatee County commissioners decided against lobbying for Medicaid expansion when the Florida Legislature convenes next spring, even though an expansion could shrink county health care costs, officials said Tuesday.

During a discussion about a preliminary "wish list" for 2014, several commissioners opposed expansion of the health care program for the poor under the federal Affordable Care Act, which has offered Florida $51 billion over 10 years to insure more people.

"Just to focus on our local issues, and considering the local health care expenditures the county is making each year, the intent here would be that if Medicaid was expanded, more patients are eligible for that Medicaid, and ideally, the county's costs then shrink," said Nick Azzara, county information outreach coordinator.

"I understand it's a very political issue, but I thought in the interest of local finances, it would probably help," he said.

"I hope that's just your opinion," retorted Commission Chairman Larry Bustle.

Bustle said Medicaid expansion was supported by Gov. Rick Scott during this year's legislative session, but

opposed by the Florida House "for some very interesting and plausible reasons."

"I don't know, I think that was one we need to step lightly around," Bustle said.

Azzara replied: "You know as well as I do that the winds change frequently, and I think the conversation's going to be had again in Tallahassee, and will be a top issue this year, and so, I figured I'd throw it up for you to consider."

Weighing in as a small business owner and a commissioner, Vanessa Baugh predicted expansion: "is not going to happen in the state of Florida.

"It's great the federal government is willing to give us $50 billion, but we don't know after two years where the money is going to come from," she said. "And then, what are we going to do because we're going to have all these people on Medicaid we're not going to be able to afford to service as a county?"

Commissioner Michael Gallen smiled and said: "We're all reasonable, and we all disagree."

Gallen wanted to hear more about how Medicaid expansion could affect the county "as regards indigent care."

The board decided without consensus, Medicaid expansion should not be placed on its "wish list."

Gallen had opposed a recent referendum to approve a half-cent health care surtax, which would have generated $23 million annually for indigent care.

He wanted the election held next year to provide time for the county to develop a comprehensive plan for care.

In a June 18 referendum, voters turned down the surtax, and now the county is expected to run out of money for indigent health care by 2015.

Six of seven commissioners get their health insurance through the county group plan, according to Deputy County Administrator Karen Windon.

That includes Commissioners Baugh, Gallen, Robin DiSabatino, Carol Whitmore, Betsy Benac and John Chappie. Bustle is a retired U.S. Air Force veteran whose health insurancer is carried by Medicare and through the military.

Under terms of the county plan, an individual employee pays $70 a month, with the county picking up $503. For employee-only coverage, the county pays $6,036 annually, or $7,692 per year for family coverage.

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