Time to act on health care for working poor

The relentless calls over the past two years for the Florida Legislature to address health care coverage to the uninsured finally appear on the verge of a solution. Those working poor sit hopelessly in the Medicaid coverage gap.

The state House, once the unmovable force against accepting federal money for expansion of Medicaid under the Affordable Care Act, now appears amenable to taking billions of dollars. But only should the federal government grant a waiver to allow the Sunshine State to adopt its own version of health insurance for the working poor.

That House proposal, called "A Healthy Florida Works," is a version of the state Senate plan that pays for private insurance instead of a government entitlement, a far more palatable strategy for a conservative Legislature. Those low-income Floridians number up to 1 million, earning more than the federal poverty level and more than the ACA threshold for Medicaid coverage. Those people are denied any type of government assistance on health care.

But several factors have changed the equation in Tallahassee. Two powerful business organizations, the Florida Chamber of Commerce and the Associated Industries of Florida, last week sent policy papers to lawmakers supporting Healthy Florida and acceptance of federal dollars.

This arrives after the health care industry and other economic interests stood up in favor of Medicaid expansion. Just last week, a consultant commissioned by the state noted that the state's hospitals could loss around $1.3 billion in federal money in the treatment of poor and uninsured patients without Medicaid expansion.

That should be a concern in Manatee County, but commissioners are standing by the once firm GOP opposition to Medicaid expansion even though the county faces a depletion of the trust fund dedicated to indigent care.

Florida already faces the loss of a significant source of federal funds, too, with supplemental funds known as the Low Income Pool set to end in June under an agreement with the federal government. That should ring alarm bells even louder in Manatee County. That will further strain government's ability to reimburse the private sector for health care to the working poor and the indigent.

A Healthy Florida Works is not some handout to what many consider to be "lazy" people unwilling to take care of themselves.

The program requires "personal accountability" with recipients paying monthly premiums. Enrollees must also work or at least be seeking employment, which could be troublesome to federal approval of a waiver. But this is a common sense approach to responsible citizenship.

As Rep. Greg Steube, R-Sarasota, told this Editorial Board, this plan offers a real health insurance plan in the private market -- "a smart look at the issue." This, he says, offers quality health care much better than traditional Medicaid, where doctors are reimbursed at such low rates they do not participate.

Florida is ready for movement on medical care for the working poor, and in particular Manatee County. The Legislature, especially the House, should be mindful of all the many ramifications of this issue -- from business, health and community quality of life reasons.