Push for Medicaid expansion gains steam with businesses in Florida, but not lawmakers

Last week a coalition including business groups released a proposal that would extend private health insurance to hundreds of thousands of low-income Floridians. Called “A Healthy Florida Works, it borrowed some elements from the Joe Negron sponsored bill in the Florida Senate in 2013 that would be funded though the billions of federal dollars available under the Affordable Care Act, but would use a state-operated private insurance marketplace, where eligible people could choose among health plans. Also, it would require participants to be involved in such activities as job searches, job training or educational programs.

“The proposal really speaks to the increasing momentum the campaign to close the coverage gap is gathering,” says Athena Smith Ford, Advocacy Director for the health care advocacy group Florida CHAIN. She was participating on a conference call on Wednesday sponsored by the Center for American Progress  to discuss how the Affordable Care Act is working in Florida. “Overwhelmingly, Florida constituents want to see the Florida coverage gap closed.”

In fact, support for Medicaid expansion in Florida has been remarkably consistent since the Florida Legislature rejected the idea in 2013. A Public Policy Polling survey from this past September showed Floridians supporting that measure by a 61-27 percent margin.

On its website, the organizers behind A Healthy Florida Works Plan claim the plan is based on “free market principles” where private insurance providers elect to participate and consumers have choices. Individuals and families would choose a health plan through a state private operated online health insurance marketplace. To be eligible, participants must meet certain annual income levels, pay nominal premiums and participate in job and education training activities. Premiums paid by enrollees are reinvested into accounts that can be used for additional health services or education. Participating private providers will be paid on a per member, per month basis.

Florida CHAIN’s Athena Smith Ford said her group isn’t totally running with supporting the plan just yet, telling reporters that her organization is still reviewing the proposal. “We have concerns about work requirements and cost sharing requirements, as these can be burdensome barriers for care for our most vulnerable citizens” she said.

The focus of the conference call was to remind Floridians that the deadline to sign up for a health care plan via the ACA is just days away. Citizens must sign up by December 15 in order to have coverage beginning on January 1, 2015.

“The data is very clear,” said Dr. Frederick Southwick, Professor of Medicine at the University of Florida Health. “For every 830 lives covered, one life is saved. That means for a million people, that would be 1,200 lives saved each year if the Florida Legislature supports coverage for this group,” he said, referring to that segment of the population who don’t already qualify for Medicaid because they make too much money, but not enough to afford health insurance.

Members of the group Florida Legal Services, a nonprofit legal advocate for the poor, said last month that Florida legislators’ refusal to expand the eligibility criteria for Medicaid as called for under the ACA might cost billions of dollars in lost funding for hospitals that treat many uninsured patients.

As the Miami Herald reported, those anticipated funding cuts derive from a series of agreements between Florida and the federal government, and the intent of President Barack Obama’s healthcare reform law, which had anticipated that more Americans would have access to insurance under the ACA, reducing the amount of uncompensated care delivered by hospitals. But the biggest loss stems from a July 2014 agreement between Florida and the Centers for Medicare and Medicaid Services, which administers the healthcare programs on the federal level. That agreement calls for the elimination of about $1.8 billion a year in statewide funding through the Low Income Pool program starting on June 30, 2015.

But the Legislature still seems immune to all of this. After Tampa area Democratic Senator Arthenia Joyner suggested last month that Sen. Negron might lead another effort toward some kind of Medicaid expansion for the 2015 legislative session, the Republican from Stuart responded that he had no interest in pushing for his hybrid approach.