Friday the Florida House soundly rejected a Medicaid expansion compromise that even supporters admitted had its flaws and was seemingly doomed to fail almost from the start. The bill, which tore apart the regular session as the House and Senate bitterly disagreed, was voted down 72 to 41 with all 37 Democrats and four Republicans voting yes.
It was yet another rebuke of the Obama administration’s efforts to expand health care to the uninsured, Florida’s Republican-led House of Representatives soundly rejected a plan on Friday that state officials said would have covered as many as 650,000 residents. Florida will lose $1 billion by July if Medicaid is not expanded. That money is part of a program that helps public hospitals pay for the unreimbursed cost of patients who cannot pay their bills, and legislators are trying to find ways to make up the shortfall.
It was the third time that legislators had considered and spurned some version of health care expansion since passage of the Affordable Care Act, and it represented a victory for Gov. Rick Scott, who had changed his mind in the past on whether to support any such enlargement but was firmly opposed this time.
But the Republicans dominated House insisted it would still expand President Barack Obama’s health care overhaul and increase the federal deficit. Some Democratic supporters in the House were not pleased that the Senate compromised that the bill would cover far fewer people than the 800,000 who are eligible. Gov. Rick Scott was also strongly opposed and if the compromised bill were to be passed it would be vetoed the moment it his desk.
The Florida Health Insurance Affordability Exchange would have used more than $18 billion over 10 years in federal funds to expand the pool of low-income Floridians eligible for health insurance and help them buy it from private providers.
Instead, House Republicans, using their 81-to-39 majority and an almost uniform opposition to using federal dollars to broaden the pool of patients covered under Medicaid, criticized the new plan, calling it nothing more than Medicaid expansion under another name.
“While today’s debate is over and votes have been cast, the critical health care challenges facing Florida still remain,” Senate President Andy Gardiner said in a statement.
The Senate revamped the bill earlier this week to address several concerns raised by the House, adding measures that would end the program after three years and strengthening a work-requirement component, although federal health officials would likely not approve the latter. The proposal also required recipients to pay small monthly premiums.
But despite any evidence to support their claims the House Republicans warned the expansion could put taxpayers on the hook for billions of dollars and that the Obama administration may back out of its promise to pay the entire bill for the first few years and 90 percent after that. They also feared that a larger than anticipated number of recipients would sign up, further increasing the financial burden on the state.
Census Bureau figures show that 4.8 million Floridians, or 24.2 percent of the state’s population, are uninsured, compared with 15.3 percent nationally.
Rejection of the bill came despite an appeal from the chairman of the White House Council of Economic Advisers, Jason Furman, who argued in a report issued by his office on Thursday that a vote to expand Medicaid coverage in Florida “would have major health benefits for its low-income citizens.” The report said that Florida’s price tag for uncompensated care would be $790 million lower in 2016 if expanded coverage were fully in effect.
The bill’s failure means that its proponents will not have another chance to expand coverage until next year. The vote came during a special session, scheduled to end on June 20, that was called to prepare and vote on a budget.
Senate President Andy Gardiner and House Speaker Steve Crisafulli announced they have reached a broad deal on a new state budget, including how much will be spent on education and health care.
*Some information used in this story came from Associated Press reports.