Christine Jordan Sexton
The effort to bring Medicaid expansion to Florida will have to wait at least another year — even though many other southern states that resisted the expansion offered under Obamacare have had second thoughts and changed direction.
The question is whether Florida will be one of the last states in the nation to enact expansion — similar to how it was among the last states to enact the initial Medicaid program that was first authorized in 1965. Florida did not come on board until five years later.
“If Congress were to ever repeal Medicaid expansion and Obamacare, I’d be the first in line in support of that,” said state Rep. Joel Rudman, a conservative Republican and doctor who now says Florida should support expansion. “But the fact of the matter is, they are never going to. And when you escape that reality, to simply refuse federal dollars for a program that’s never going away is just absurd.”
After North Carolina voted to expand Medicaid, other southern states, including Mississippi and Georgia, have been considering doing the same.
Republican lawmakers in Mississippi, the poorest state in the nation, are debating the issue now, with the House approving legislation earlier this month. Republican Gov. Tate Reeves, though, posted his opposition to the proposal on X, formerly Twitter.
Georgia House Speaker Jon Burns, a Republican, told the state chamber of commerce in January that “expanding access to care for lower-income working families through a private option — in a fiscally responsible way that lowers premiums — is something we will continue to gather facts on in the House.”
Medicaid expansion, as it has been in the past, was a no-go in Florida this year. Senate President Kathleen Passidomo, who led the charge to push through a health care workforce overhaul this year, remained adamantly opposed to expansion, as did other legislative leaders and Gov. Ron DeSantis.
That didn’t stop Rudman, however, from trying to build groundwork for another try.
Rudman met with North Carolina state Sen. Kevin Corbin in Tallahassee this Session to discuss the steps that Florida could take toward expanding Medicaid, as well as North Carolina’s experience since passing and implementing a Medicaid expansion effective Dec. 1, 2023. Rudman also arranged to have Corbin meet about a dozen Republicans to talk about the issue.
“North Carolina was very hesitant to take Medicaid expansion. You know, three, four or five years ago, there was a lot of hesitation among Republicans who felt like it was a buy-in to a continuation of Obamacare, and that we would be spending money loosely,” Corbin told Florida Politics in February at a meeting in Rudman’s Capitol office.
“So over a period of four or five years, I think we’ve come to understand — and folks like myself have been the ones to promote it — that it was going to be good for our citizens.”
Corbin said the North Carolina expansion — the state portion of which is funded by revenues from hospitals — is expected to cover 600,000 new people.
“As a Republican and as a conservative, I would agree with a lot of my colleagues that if there was, if there was a private industry solution to this, we should take it,” Corbin said. “It’s been 14 years. There hasn’t been a private industry solution or a private solution. This worked. So it’s a matter of: Are we going to address this coverage gap? And in North Carolina, have we come to a decision? Yes, yes, we are.“
Under the Affordable Care Act, the federal government pays 90% of the costs of expanding Medicaid to childless low-income adults; the states are responsible for the remaining 10%. The American Rescue Plan Act passed in 2021 includes an additional 5% bump for Obamacare expansion for the first two years following a Medicaid expansion.
Corbin was invited to Tallahassee by an umbrella organization promoting better health care access called For Florida’s Health, of which The American Cancer Society Cancer Action Network (ACS CAN) is a member.
ACS CAN Florida Government Relations Director Susan Harbin said her organization is excited about the bipartisan conversations that she said are occurring in Florida, a state where less than 40% of the employers offer health insurance to employees. Plans that are offered can be costly and out of reach for many of the workers.
“More than 160,000 people will be diagnosed with cancer in the Sunshine State this year. We know having health insurance is the main determinant of whether people survive the disease. In addition, states that have closed the coverage gap give patients a significantly better chance of cancer survival,” she said.
Corbin acknowledged that in North Carolina, politics was the driving reason initially behind the state’s decision to not expand Medicaid to lower-income uninsured adults.
“Early on, I think a lot of folks were afraid that if we voted for Medicaid expansion, if we supported that, we would be criticized by our party, and a lot of us would be subjected to Primary Elections that folks run against us for that reason. And they would come at us with, ‘Hey, you’re, you’re supporting a Democrat initiative,’ and those kinds of things,” he said.
But none of the Republicans in that state’s Senate were facing a Primary challenge as of mid-February. “People can have a Primary for any reason, including (Medicaid expansion). So it just has not been a political issue in North Carolina,” he said.
A March survey of 800 likely General Election Florida voters shows that 60% of them are more likely to vote for an elected official who supports a Medicaid expansion, whereas 13.4% would be less likely to vote for an elected official who supports an expansion.
A majority of non-college-educated voters, a key bloc in Florida elections, are more likely to vote for elected officials who support a Medicaid expansion. Another 11.5% said the support of a Medicaid expansion wouldn’t impact how they voted, and the remaining 13.6% said they were unsure.
The survey results were posted shortly after organizers began a campaign to put Medicaid expansion on the 2026 ballot, when there will be a wide-open race for Governor.
In a sign that Medicaid expansion still remains a touchy issue with some Florida Republicans, though, Rudman declined to name the legislators who met with Corbin out of fear of retribution.
“After having five of my last seven bills killed after coming out in favor of Medicaid expansion, I have no desire to return the favor on those who are willing to listen to reason. They can make themselves and their own feelings known, but I will not out them publicly,” he said. “It was common knowledge around Tallahassee. Lobbyists I never met were stopping me in the street saying that’s what happened to my bills.”
25 comments
Hung Wiil
March 18, 2024 at 3:04 pm
Rep Rudman is just plain wrong. First, North Carolina has a total state budget of $30 billion, while Florida’s is nearly four times larger with NC having half the population of Florida. Florida spends more, currently, on Medicaid than the entire state budget of North Carolina!!
It says Mr Rudman is a conservative . . . balderdash. The federal government doesn’t have any money to send the states. He should check that it is $34.5 trillion in debt, adding $1 trillion each 100 days to the debt. But his argument is well, since the feds are handing out money, we should have our hand out too. This is not conservatism. Somebody primary this dude.
Micro Wiil
March 18, 2024 at 7:31 pm
‘Balderdash’?
Ok Winston Ledgercombe IV…
GoFundMe Financial Plan
March 18, 2024 at 7:33 pm
Hand-out Floridians
Dont Say FLA
March 19, 2024 at 11:44 am
If Florida’s population is only twice that of North Carolina’s, why does Florida’s G0P require four times the budget?
Now don’t nobody go and say it’s because Florida’s bigger. Florida is only 20% bigger than North Carolina, and the Everglades account for that.
Ain’t too many government services available for the alligators, pythons and panthers living in Florida’s extra 20%, the Everglades, so NC and Florida are effectively equal in habitable landmass.
What is wrong with Florida’s G0P that they require 4x the budget of NC?
Michael K
March 18, 2024 at 6:54 pm
Florida is an outlier on this. Only 10 states have refused. Even deep-red Missouri finally expanded Medicaid – because voters overwhelmingly demanded it. Why do Florida Republicans like to see poor people and children suffer?
Hung Wiil
March 18, 2024 at 7:27 pm
Michael,
Your reliance on emotional appeal demonstrates the vapid nature of the commentary; a total lack of substance.
The poor and children do not suffer in Florida. Florida spends more on health care for children and the poor than the entire budget of the state of Missouri. There are numerous programs available, including Florida Kid Care, which counters your baseless opinion. You’re not a serious person, Michael. Medicaid expansion is folly because the program is not worthy of expansion, but only contraction. It is the quintessence of inefficiency.
How shocking, the voters in Missouri voted to expand government and have someone else pay for it. What courage!
In the real world, Florida and Texas have not expanded Medicaid, and those states have surpluses of $17 and $32 billion respectively and are the fastest-growing states. New York and California have deficits of $10 and $38 billion respectively and are the two states losing the most population as a percentage.
If you want to thrust your state into economic decline and budget cuts, then expand Medicaid. By the way, what is so cool about the poor? Are the poor really awesome, and I’m just not getting it?
Michael K
March 19, 2024 at 1:02 pm
The ten non-Medicaid expansion states have the highest rates of uninsured people in the nation – Florida has nearly 20% of Americans in the coverage gap – Texas has more than 40%. And those in the coverage gap are overwhelmingly people of color, which explains why the states that have refused are mostly southern states. Sadly, though there has been some improvement, more than 10% of people in Florida have no health insurance.
Hung Wiil
March 20, 2024 at 9:25 pm
Michael,
The information you provided is erroneous. Nevada, Arizona, New Mexico, and Alaska have higher uninsured rates than non-expansion states. Texas is 17% uninsured, not 40% as you stated. The Census Bureau has all the data.
Southern states like Florida have 18% black population, and Massachusetts has an 8.5% black population. The black population is much, much, much higher in southern states, so the statistics make sense. All of these uninsured are already eligible for numerous federal and state health programs. Color has nothing to do with it. So, your facts are wrong, there is no racism involved, and Medicaid is still a loser program.
JD
March 20, 2024 at 9:43 pm
The data from recent reports offers a nuanced picture that can help clarify the statements made in both comments.
Firstly, regarding the uninsured rates in the United States, Texas does indeed have a high uninsured rate, but not as high as 40% as claimed in the first comment. According to the latest data, Texas has an uninsured rate of approximately 18%, which is the highest in the nation. This contradicts the claim in the second comment that Texas has a 17% uninsured rate, which, while close, undershoots the actual figure slightly.
Florida’s uninsured rate is reported at around 12.1%, not nearly 20%. This is significantly lower than the rates suggested in the first comment but still points to a substantial uninsured population.
As for the claim that Nevada, Arizona, New Mexico, and Alaska have higher uninsured rates than some non-expansion states, this is partially accurate. Alaska’s uninsured rate is indeed high at 11.4%, comparable to the rates seen in non-expansion states. However, the assertion that these states universally have higher uninsured rates than all non-expansion states is not accurate when considering Texas and Florida’s actual rates.
The uninsured rates among different racial and ethnic groups reveal disparities, with higher uninsured rates observed among Hispanic and Black populations compared to White and Asian populations. This adds complexity to the discussion about the intersection of race, healthcare coverage, and Medicaid expansion.
It’s also important to note that Medicaid expansion states tend to have lower uninsured rates. This is evident in the data showing that adults and children in expansion states are less likely to be uninsured compared to those in non-expansion states. This supports the idea that policy decisions at the state level have significant impacts on healthcare coverage disparities.
Both comments contain elements of truth but also inaccuracies or oversimplifications of the issues at hand. The nuanced reality is that uninsured rates vary widely by state, influenced by factors like Medicaid expansion, socioeconomic status, and race/ethnicity. These discrepancies highlight the complex interplay of policy, demographics, and healthcare access in the United States.
rick whitaker
March 19, 2024 at 1:52 pm
hung wiil, on this issue you are an idiot. i will not waste my time explaining it to you. based on the comments you made, you know little on the subject, too little for me to help you.
Greta Popilinosious
March 19, 2024 at 3:42 pm
Thank you, Rick. That’s exactly what I was going to respond, but it’s kind of a waste of time and energy replying to a person with no fundamental knowledge of the or care about other people.
Christian Nationalism
March 18, 2024 at 7:32 pm
The Bible sez so
Hung Wiil
March 18, 2024 at 8:09 pm
Not really. It seems you’re not well-read.
rick whitaker
March 19, 2024 at 1:47 pm
cn, great comment, made me chuckle. my wife hates x-tians as much as i do, so she chuckled too.
rick whitaker
March 19, 2024 at 1:57 pm
michael, hung wiil does not understand the economics or politics of american healthcare, you seem to.
Hung Wiil
March 20, 2024 at 2:10 pm
Rick,
You are clever; say nothing, declare victory, and then you win. How convenient. You really are a masterdebator.
Get out the Jergens!!
rick whitaker
March 20, 2024 at 2:21 pm
hung, i thought i said quite a lot, you know nothing, if someone of erudition, or advanced experience told me i knew nothing, i would consider that something, not nothing. how old are you 20 or 25 ?
Hung Wiil
March 20, 2024 at 2:26 pm
Rick,
Asking my age, and assuming I am not far removed from teenage years, demonstrates how creepy you are, along with your stupid avatar.
You have advanced experience at jacking off, and there it ends.
rick whitaker
March 20, 2024 at 2:47 pm
hung my assumption that you were young was because your posts seem so immature to me. i don’t know where you get all that perv shit from, i was coming from a more intellectual philosophical point of view. why do you keep going in that direction? any way my stupid avatar is a 3 year old or so picture. i now have a long beard and long hair. i’m not a picture freak, that is the only pic i had on my pc when i posted it. you are angry and lack knowledge, that, i do know.
Hung Wiil
March 20, 2024 at 3:01 pm
Rick,
You are projecting again.
rick whitaker
March 20, 2024 at 6:08 pm
listen hung, you wouldn’t know projection if you seen it. unfortunately for you , you are very transparent, and therefore a waste of my time. was my 20 year old guess too old for you, i was trying to err a little in your favor to prevent embarrassment on your part. if you were as smart as you think you are, i wouldn’t have to be explaining all this to you. don’t bother leaving a comment, i don’t have time for your type.
John L
March 19, 2024 at 9:52 am
Maybe if Medicaid gave campaign donations to DUH Santis, it would get passed. Crook
Hung Wiil
March 19, 2024 at 12:44 pm
Wow, John. How enlightened. The world is a great place with you in it.
John L
March 21, 2024 at 8:13 am
That what the insurance industry did and wat a surprise, they got a gift where they don’t have to pay for court costs when they lose lawsuits so now they can stall and pay pennies on the dollar for legit insurance claims.
Dont Say FLA
March 19, 2024 at 2:04 pm
They gonna have to expand Medicaid if any medical practitioner in Florida wants to get paid after people pay their insurance and have nothing left to give
Comments are closed.