“It’s like Déjà vu all over again” is one of my favorite “Yogi-isms” and it’s been looping on repeat in my head like an earworm.
I’m referring to the Florida Senate’s latest attempt to revise its healthcare FHIX proposal and, yes again, expand Medicaid. The new plan will be called many things to attract broad support, but Floridians should do their homework.
Supporters of the plan hope Floridians will be attracted to claims that this is a free-market approach to healthcare. Unfortunately, seeing beyond the rhetoric, the revised plan still relies on accepting tens of billions of dollars in federal Medicaid expansion funds.
Additionally, when you strip away the proposed individual contributions and work requirements (facets of the plan meant to thrill conservatives, but which the federal government will ultimately reject), what you’re left with is nothing more than a Trojan Horse for complete Medicaid expansion under Obamacare in Florida.
Borrowing a concept already attempted, and proving to be an abject failure in several states, supporters are saying the modified FHIX proposal is an “even more conservative” silver bullet to Medicaid, calling it a “private option” that addresses everyone’s concerns.
Make no mistake – this plan will surely cost Floridians. Take the example of Ohio – under pressure in 2014, Gov. John Kasich decided to expand Medicaid and the results are unfortunate, but not shocking.
A new report issued by the nonpartisan group Watchdog indicates that the experiment will cost Ohio taxpayers more than $1 billion more than the initial projection in just the first full year, for an additional 470,000 Ohioans. With more than 800,000 expected to be added to the rolls in Florida, basic math should make any Floridian cringe at the sheer financial cliff we are driving headlong toward.
In addition, a seldom-reported fact of this debate needs to be emphasized. The overwhelming majority of the Medicaid expansion pool is comprised of childless, working age, able-bodied adults.
Due to the perverse incentives of this federal program, these individuals will face a massive cost increase when they move from 138 percent of the poverty line to 139 percent. By earning just a little more in income, individuals open themselves up to thousands of dollars in deductibles, copayments and unreimbursed charges. This fact makes the healthcare delivery system antithetical to common sense policy and the pivotal reason for needing to address the root of the problem – healthcare access and cost.
Great ideas exist to fix the system. The Florida House of Representatives, for example, recently put forth thoughtful proposals for this special session to address the root cause of the challenges we face in access to healthcare and the cost of service.
These common-sense reforms, such as addressing scope of practice with nurse practitioners and physicians assistants, eliminating the archaic and job-killing Certificate of Need regulations and pushing reforms that would grant ambulatory surgical centers the ability to keep patients overnight, are exceptional policy proposals that will start to address Florida’s needs for healthcare innovation.
The James Madison Institute and other groups have proposed additional reforms that would complement these efforts – expansion of telemedicine, to encourage service delivery to hard-to-reach populations; price transparency, an absolute necessity for progress in cost containment; and medical malpractice reform, which will help bend the cost curve and restore economic sanity to our healthcare system.
A true, responsible Florida solution will protect the taxpayer, have the characteristics of market forces at work and mean less intrusion on the part of the federal government, not more.
Sal Nuzzo is vice president of policy for the James Madison Institute.