Christine Jordan Sexton
Despite testimony urging them to be wary of tapping into any increased Medicaid funding, the Senate Appropriations Subcommittee on Health and Human Services on Tuesday passed its Medicaid expansion bill that would provide coverage to an estimated 800,000 uninsured Floridians.
Though the committee had been given three hours to debate and discuss SB 7044, sponsored by Fernandina Beach Republican Sen. Aaron Bean, it moved the bill in less than one hour. It passed unanimously despite opposition from Americans For Prosperity as well as the National Federation of Independent Business, Florida.
Americans for Prosperity lobbyist Skylar Zander warned against using federal funding for health care and said health care is a state’s rights issue. Zander warned the committee that a bureaucrat in Washington, D.C., could abruptly change the rules, which would force the state to redraft its health proposal.
Sen. Joseph Abruzzo, a Democrat of Wellington, questioned whether Zander was aware of all the federal matching funds in Florida’s budget in areas such as transportation and education in addition to health care.
“I’m very aware,” he replied. “And that does not mean that I believe in those programs, either.”
NFIB Florida Executive Director Bill Herrle — whose group was behind the first U.S. Supreme Court challenge of the federal health care law — said the state should not move ahead with an expansion out of fear of losing Low Income Pool dollars. LIP is a $2 billion plus pool of supplemental Medicaid dollars the state uses to fund uninsured and underinsured. It goes mostly to hospitals, but also is used for federally qualified health centers, graduate medical education, and even prepaid health plans. The federal government advised Florida last year that LIP would not be expanded beyond June 30, 2015. Now the Legislature is scrambling to replace LIP or build a budget without the money.
Though the SCOTUS found the health law constitutional the court did rule that the federal government couldn’t withhold Medicaid money to states that didn’t expand Medicaid to working uninsured. Herrle urged the Legislature to “stand up to this and reject this Medicaid expansion when it’s being done under this duress.”
Herrle said his group supported direct patient care — which is being pursued in the House — and even would support Florida using state revenue to help provide health care to Floridians.
Committee Chairman Sen. Rene Garcia, a Hialeah Republican, chided Herrle for supporting Florida dollars for health care but not federal dollars.
“You’re asking taxpayers of Florida to be double taxed in order to receive health care?” Garcia asked Herrle.
Not all the opposition came from the audience. There were rumblings from some of the Democrats on the committee with some of the provisions in the bill. Those concerns ranged from cost-sharing requirements that would be placed on poor Floridians to some of the educational and work requirements that would apply to those who enrolled in the program.
Other concerns centered on the Agency for Health Care Administration’s oversight over the Medicaid expansion and why the little known Florida Health Choices Program would administer the program and not the more well known Florida Healthy Kids Corp.
Hollywood Democrat Sen. Eleanor Sobel had six amendments that would have addressed all the Democrat’s concerns but she withdrew them.
Abruzzo told Bean that if the bill were in its final form on the Senate floor he couldn’t support it and that he wanted to see some of the amendments Sobel withdrew eventually be included in the Senate measure.
Abruzzo also said he had “issues” with opponents arguing against the bill because Florida would rely on federal Medicaid dollars to provide the insurance. He noted that the majority of the state’s budget is comprised of federal funding.
“Without the federal government, we would have a Mad Max Florida. it would be out of control,” Abruzzo said, adding that the federal government is Florida’s partner. “We are America. That’s what it’s all about.”
