Do some good with gambling: Expand Medicaid | Editorial

The Seminole gambling compact that the Florida Legislature is considering in special session this week anticipates $2.5 billion in new state revenue over the next five years but doesn’t propose how to spend it. That’s an awful lot of money to leave to the discretion of people whose first instincts are to cut taxes for special interests rather than invest in making the state a safer and healthier place to live.

So here’s a suggestion to senators and House members from Broward, Palm Beach and other enlightened corners of our state: Amend the legislation to prioritize the new money for expanding Medicaid under the Affordable Care Act of 2010.

Don’t worry about whether you have enough votes to adopt that amendment. It’s time to put every lawmaker on record. Of the dozens of bills introduced to expand Medicaid during the regular session, none got out of committees or were even heard there except for a provision in the appropriations act to provide a year’s extended overage for women on Medicaid who give birth. That provision is commendable, but the failure to do more was cruel, spiteful and self-destructive.

The point that’s so sadly lost on Florida’s recent governors and legislators is that the money spent on health care for poor people doesn’t go to them. It goes to the benefit of doctors, hospitals and pharmacies.

Expanding Medicaid to everyone eligible under the 2010 law would extend health insurance to an estimated 800,000 Floridians or more, most of them working adults without children who are eligible neither for Obamacare insurance premium supplements or basic Medicaid.

Congress didn’t intend for there to be a gap, but the Supreme Court overturned the part of the law requiring expansion. That left the carrot but not the stick.

Even then, the top income limit would be 138% of the federal poverty level, which is about $17,609 for an individual or $23,709 for a couple. That’s barely enough for subsistence.

Florida is one of only 14 states, all of them Republican-led, that still haven’t expanded Medicaid. Eight are in the South. But 11 other Republican states are on board and two others are considering it. What’s good for Utah should be good for Florida as well, or is it just that kinder people live out there?

The fallback excuse of Florida leadership has been a concern over whether the federal government will keep funding its expansion share at the present 90%. But Congress has given no reason to doubt that, and the American Rescue Plan, the coronavirus relief law that President Biden signed, essentially makes the expansion cost-free to states for the next two years. Afterward, the Seminole gambling money would be more than sufficient to cover it.

Gov. Ron DeSantis and his allies in the Legislature are doubtlessly salivating over how to spend the gambling bonanza, but this is no time to trust their instincts. During the regular session, the Legislature finally agreed to require out-of-state merchants to collect and remit Florida’s sales tax. That amounts to a tax increase on Florida consumers of about $1 billion a year. The Legislature promptly earmarked it to reducing the taxes that businesses pay into the unemployment trust fund.

The moral imperative for earmarking the gambling revenue to a good purpose goes beyond simply the health needs of so many uninsured Floridians. Despite its popularity, gambling is widely and rightly viewed as a vice. It is addictive to many people, and when they suffer from unaffordable losses, so do their families and society as a whole.

The Seminole compact is the vastest expansion of gambling in Florida’s history despite the revision this week to eliminate the possibility of online casino games. Among other things, it still would legalize sports betting and fantasy sports betting for persons over 21 on terminals and smartphones linked to Seminole servers. That puts gambling on every desktop and in every pocket.

Whether that aspect is even legal remains in question. What’s not in doubt is that the compact requires no more than $250,000 a year in contributions to the Florida Council on Compulsive Gaming. That is woefully inadequate and calls for another amendment.

Speaking of “gaming,” the euphemism of choice throughout the legislation, the omission of the letters “b” and “l” don’t change a vice into a virtue. Wherever the word appears, it should be amended to “gambling.”

If it’s inevitable — and we believe both passage in the Legislature and lawsuits over voter approval certainly are — let the gambling money at least be committed to a wholesome purpose.

The Sun Sentinel Editorial Board consists of Deputy Editorial Page Editor Dan Sweeney, Steve Bousquet and Editor-in-Chief Julie Anderson. Editorials are the opinion of the Board and written by one of its members or a designee. To contact us, email at [email protected].

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