Benefits of Medicaid expansion under ACA can't be ignored

July 13, 2014 

Gov. Rick Scott made a campaign swing in Bradenton in May 2014.PAUL VIDELA/Bradenton Herald

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The consequences of Florida's failure to expand the federal Medicaid health care program for the poor have come into sharper focus.Gov. Rick Scott and certain Republican legislators continue to spurn billions in federal money over a rigid ideological stand, leaving hundreds of thousands of Floridians without health insurance.

The White House Council of Economic Advisers released a state-by-state analysis of the ramifications of Medicaid expansion, covering health and economic impacts. The "Missed Opportunities" report's conclusions supply ample justification for expansion.

Manatee County, with its indigent health care crisis about to worsen as a special medical reimbursement fund expires, would benefit greatly from a broader Medicaid program.

Here are some of the study's major points:

Economic impacts

• In Florida, 63,800 fewer jobs -- mostly in health care -- from 2014 to 2017 with $15 billion in federal spending lost. That time span covers the years when the federal government would pay 100 percent of expansion costs (that figure falling to 90 percent thereafter).

• Those dollars would have increased economic activity, too, as that money flows from place to place. The state's gross domestic product would rise by $11.2 billion during that time span.

• Some 38,000 fewer Floridians would experience "catastrophic out-of-pocket costs in a typical year" and 120,600 fewer residents would need to borrow money to pay medical bills or skip payments.

Health benefits

• An additional 848,000 Floridians would have health insurance.

• Most important for Manatee County, the report states that Medicaid expansion is likely to produce large savings on other items in state budgets, particularly in the costs of uncompensated care.

These two points have long been a part of Manatee County's solutions to the indigent care crisis, though a concrete program remains elusive:

• The working poor would receive clinic care, including access to a primary care physician's office.

• More people would receive recommended preventive care annually. Statewide, cholesterol screening would increase by 123,600 people, mammograms by 35,300 and pap smears by 52,200.

• With greater access to medical care, health outcomes will improve. The report estimates that an additional 113,000 Floridians would report good, very good or excellent health.

• The number of residents experiencing depression would drop by 68,000.

• The costs to states for providing mental health services would fall with Medicaid expansion.

Working poor assistance

Under the Affordable Care Act, individuals with incomes under 100 percent of the federal poverty level are ineligible for tax credits and cost-sharing assistance through the health insurance exchanges, and those people will not have access to affordable health insurance coverage -- unless states expand Medicaid.

Expansion would also lower coverage costs for people in families with incomes above the 100 percent and below 138 percent -- currently, $16,105 for a single adult and $32,913 for a family of four.

The broad benefits to Florida -- and Manatee County -- are clear. Now's the time for legislators and the governor to accept Medicaid expansion, for all the many health and economic incentives. Otherwise, voters should insist at the polls come November.

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