Congressional Democrats will seek to bypass Gov. Ron DeSantis and GOP Florida lawmakers by expanding Medicaid in Florida, perhaps by working directly with counties and cities.
In a Tuesday conference call, U.S. Rep. Ted Deutch said budget reconciliation in Congress, a procedure that would requite simple majorities in both houses, could be used to create a program in which the Centers for Medicare & Medicaid Services would "administer" through willing counties and cities in the Sunshine State.
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"What we are talking about in reconciliation is essentially going around the governor and the Republican leaders and short-circuiting their resistance with a program that would be administered by CMS," said Deutch, a Boca Raton Democrat.
Successfully doing so would end 11 years of frustration in Florida by advocates seeking to expand Medicaid, a federal and state program providing health coverage program to low income, poor and disabled residents. The opportunity to increase the pool of Medicaid recipients was initially provided by the Affordable Care Act, which offered coverage to people making up to 138% of the federal poverty level.
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However, a 2012 Supreme Court ruling tossed the Medicaid expansion mandate and left it as an option for states. Since then, 38 states plus the District of Columbia have take advantage of the federal funding.
Florida is one of 12 recalcitrant states. As a result, health care advocates have said that as many as 1 million qualifying Floridians have been denied health insurance coverage.
"The issue here is that Florida has had ample opportunity to accept billions of dollars in federal funding and consistently our governor and legislature have refused that," Deutch said, adding that the state may have past up on as much as $66 billion in federal funds in the past decade of inaction.
"It's time we do everything we can to provide coverage and not allow Republican leaders to, unfortunately, continue to put politics ahead of the well-being of the people of Florida," he said. "Let's find a way to say yes and to provide coverage that is desperately needed."
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State GOP leaders, including U.S. Sen. Rick Scott, who served as governor when Medicaid expansion first became available, have argued that recurring costs in the program make it unaffordable in the longer term.
But state Sen. Tina Polsky, D-Boca Raton, said Florida GOP opposition "just doesn't make any sense." She said Republican arguments related to recurring costs are a moot point because the federal government is offering to pay for multiple years at the outset and then 90% of the cost thereafter.
Polsky said even the 10% that would be charged to the state would be made up in savings from the billions of dollars in health costs already being incurred — from funding for hospitals and community health centers — because Florida hasn't expanded Medicaid. In addition, she noted the state just approved a $101.5 billion budget.
"We spend billions of dollars, we're just not spending it in a right way," she said. "It just doesn't make any sense to turn down this fantastic gift that we've been given."
Deutch cautioned that the fine print on the legislation hasn't been drawn although the money has been already appropriated through the 2010 Affordable Care Act and this year's coronavirus stimulus measure, the American Rescue Plan.
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But he cited two pieces of legislation that could be a vehicle. One is the Medicaid Saves Lives Act that would create a federal program to cover those in the Medicaid gap. The other is the Cover Now Act that would allow cities and counties to work with federal government to set up their own or regional Medicaid expansion programs.
"We need to look at all of these approaches as we move forward," Deutch said.
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