Janet Cruz says racism plays a part in decision to not expand Medicaid
Janet Cruz touts her Tampa roots in her effort to bring people together.

The Florida Legislature has not seriously considered a Medicaid expansion since 2015.

Sen. Janet Cruz on Wednesday contended that racism has played a role in the state’s decision not to expand the nation’s health care safety net program to low-income, childless adults as allowable under the federal law.

“In my opinion it is indeed a racist attitude to think that the poor don’t deserve health care. It’s not a privilege. Health care is not a privilege. It should be a basic right,” the Tampa Democrat said on a conference call to discuss Medicaid expansion set up by the Democratic Legislative Campaign Committee.

Legislative leaders did not immediately respond to Cruz’s comments.

Florida is one of 12 states that has not expanded Medicaid to uninsured adults as allowed under the federal law often referred to as “Obamacare.” Democratic candidates have tried to make expansion a campaign issue in the last several elections.

Proponents of a Medicaid expansion in Florida have argued the refusal to expand Medicaid leaves hundreds of thousands of residents uninsured and locked out of an expensive health care system and at risk of financial peril. Moreover, Cruz said, Florida is losing out on $3 billion.

As passed by Congress, the Affordable Care Act authorized the federal government to withhold federal Medicaid funds for traditional Medicaid programs if states didn’t expand Medicaid to low-income uninsured adults who, prior to the 2010 law, didn’t qualify for coverage.

But a 2012 Supreme Court ruling found that individual states could not be coerced into expanding Medicaid. The ruling essentially made Medicaid expansion, one of several key components of the Affordable Care Act, optional.

Jointly funded by the federal and state governments, Medicaid is the safety net program for the state’s poor, elderly and disabled. There were 5.18 million people enrolled in the Medicaid program as of March 31, according to the latest available data. Most of them, nearly 4 million, are enrolled in Medicaid managed care programs.

The Florida Legislature has not seriously considered a Medicaid expansion since 2015, when the Florida Senate’s push to expand the safety net program to childless adults derailed the regular Legislative Session.

There was an attempt to have Florida voters weigh in on the issue during the 2020 election by proposing a constitutional amendment. Those efforts failed though, and the Florida Supreme Court earlier this month slammed the door on the proposed amendment being considered for the 2022 General Election.

Still, Florida Democrats have continued to champion the issue.

Democratic lawmakers — Sens. Annette Taddeo and Victor Torres, and Reps. Felicia Robinson and Geraldine Thompson, proposed joint resolutions (SJR 412 and HJR 239) during the 2022 Session that would put Medicaid expansion on the 2022 ballot. They also filed bills (SB 1504 and HB 27) which would expand Medicaid without voter approval. But Republican leaders in the House and Senate refused to consider the bills during the Session.

While Florida has not expanded Medicaid under Obamacare, the state has agreed to take advantage of several Medicaid provisions contained in the American Rescue Plan. Florida is applying for approval to extend Medicaid benefits to women for one-year postpartum women for one year. Currently, Medicaid coverage expires two months after delivery.

The administration of Gov. Ron DeSantis also agreed to tap into enhanced federal funding for Medicaid home- and community-based services providers that was included in the American Rescue Plan.

The American Rescue Plan also offered a 5% bump in federal Medicaid dollars for existing programs and would pay for 90% of the expansion costs of covering childless adults. But Florida officials have shown no interest in taking advantage of the opportunity.

Instead of addressing Medicaid expansion, Cruz said lawmakers this Session focused on issues that she said diverted voters’ minds from more pressing issues.

“We are busy trampling on people’s rights and women’s rights and Disney World and Disneyland and books that they are banning and anything else that diverts your attention away from the redistricting that we just went through,” she said. “That’s where we are in Florida. It’s dismal but that’s where we are. It’s very frustrating to watch the abuse of power that’s happening here with the Republicans in charge.”

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.


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