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Monday, 28 April 2014 00:00

Editorial: No Medicaid expansion costing Florida dearly

Written by  tallahassee Democrat | newspress.com
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Florida's Republican leaders have made it abundantly clear that they don't like the Affordable Care Act, aka Obamacare.

With Attorney General Pam Bondi taking the lead, Florida was one of 26 states claiming that the Affordable Care Act was unconstitutional. They lost in the U.S. Supreme Court.

Florida refused to create its own health care exchange, as allowed under the high court's ruling. When states were allowed to bail out of the expansion of Medicaid under the ACA, Florida was one of the first to jump. The state spent no money promoting the new health plans available under the ACA, and it even banned so-called "navigators" at county health departments from helping people through the process of signing up.

Now, there's a new twist.

U.S. Sen. Bill Nelson, the Democrat from Florida, has been working with federal officials to find a way that Florida could expand the reach of its Medicaid program.

Recently, he said, he received a letter saying the federal government was "ready and willing" to work with Florida on a state-designed plan. Excited by this prospect, Sen. Nelson sent a copy of the letter to Gov. Rick Scott, House Speaker Will Weatherford and Senate President Don Gaetz and implored them to move ahead with Medicaid expansion.

The plan offers the state an "out" in its continued refusal to fund an expansion of Medicaid. Instead, Sen. Nelson would have counties that use local funds to support public hospitals in caring for the indigent use that money instead to cover the state's share of Medicaid expansion.

It's sort of like moving the money you set aside for groceries from one shoebox to another. The money still would be going to provide health care for those who can't afford it, though under Sen. Nelson's plan, every one of Florida counties would benefit.

There are several problems, though.

First, the hospitals aren't buying in 100 percent. They would benefit in that many of the patients who now see the emergency room as the place for very costly primary care presumably would be insured and have primary-care physicians instead. But the hospitals, some of which are on shaky financial ground, must make sure this proposal wouldn't take away more funding.

There's also the problem that the state still would have to create and administer this expansion of Medicaid.

And that ties into the third problem. The Republican leadership still despises Obamacare and intends to make it a major issue in the November elections. Television ads for Gov. Scott already are blistering his presumed opponent, Charlie Crist, for his support of the ACA.

In response to Sen. Nelson's overture, a spokeswoman for Sen. Gaetz told the Tampa Bay Times: "Utilizing local dollars to fund the state portion of an expansion of traditional Medicaid does not address President Gaetz's concern with the federal government's ability to finance Medicaid expansion in the long term or his belief that traditional Medicaid is a broken program that providers, patients and taxpayers are unhappy with."

Speaker Weatherford made clear his views recently when asked about Sen. Nelson's negotiations with federal officials: "We've learned from the Obamacare rollout debacle that you cannot trust Washington's math."

It has been estimated that Medicaid expansion could reach about 764,000 Floridians who have no way of getting affordable health care insurance now. It also would bring in about $51 billion in federal funding that the state so far has shunned.

But this isn't really about health care or even about saving lives. It's about politics.

You'd think Democrats and Republicans, the state and federal government, could work together for the good of the people of Florida. You'd be wrong.

Link to original article from News-Press.com

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