Mostly sunny forecast for Medicaid expansion
To the editor:
I would like to share the following with our state representatives from Lee County:
Dear Lee Legislators,
This was my third time speaking to you at the Lee Legislative Delegation Meeting about extending health coverage to uninsured Florida residents. I hope the third time is the charm! It was nice to see so many friendly legislators on the panel, especially those whom I’ve served with on common-issue committees.
Medicaid Expansion is a very important issue; lack of health insurance can lead to dangerous medical conditions, financial strain, and an estimated three to six deaths per day. There are 800,000 Florida residents who are in the insurance “coverage gap.” They don’t earn enough to qualify for a federal subsidy to buy a private plan on the Affordable Care Act exchange, but they earn too much to be eligible for regular Medicaid.
I think there are several factors that might encourage an acceptance of some type of Medicaid expansion by the legislation this year: the loss of federal dollars for hospital care of insurgents; the establishment of a coalition called “A Healthy Florida Works” (AHFW); a non-election year for state lawmakers; and a push by Florida Chamber of Commerce to fully insure Floridians.
There is a financial incentive to do something now. On the positive side, there’s up to 66 billion federal dollars waiting in the wings to come to our state if Florida expands its Medicaid program. On the negative side, Florida will soon be losing billions of federal dollars to compensate “safety net” hospitals to treat uninsured patients. The healthcare law has already scheduled the gradual phasing out of Disproportionate Share Hospital program funds. In addition, there will be an elimination of about $1.8 billion a year in federal Medicaid funding through the Low Income Pool (LIP) program starting on June 20, 2015.
A coalition of 700 Florida businesses and groups, including the Florida Hospital Association, are pushing for a creative, “free-market” solution. The proposed “A Healthy Florida Works” plan would require a waiver from the federal Centers for Medicare and Medicaid (CMS). This plan, which is supposedly a compromise between the state house and state senate proposals, would bring federal income taxes paid by Floridians back to Florida. It is expected that Florida would net a savings of $1.76 billion from 2015 through 2020.
This AHFW plan would be for anyone making less than 138% of the federal poverty level, approximately $16,000 per year for a single person or about $33,000 for a family of four. The plan would require monthly premiums, which would be held in individual savings accounts, and the plan would require the insured to search for employment or enroll in job training programs. The plan would be administered privately instead of through the state, and the federal government would pay participating private providers per member on a monthly basis.
The powerful Florida Chamber of Commerce is advocating for health care for all, but they haven’t completely bought into the AHFW program yet. Among other things, they would like savings from plan be used to pay back Florida workers and businesses for higher health insurance premiums that are charged due to uncompensated care of the uninsured.
I’m rooting for “A Healthy Florida Works” plan, but I’m concerned that the CMS might reject the alternate solution because it has added premiums. Hopefully, it will be a starting point for negotiations. If this plan doesn’t work, why not go back to the Obamacare model for Medicaid expansion? It’s really a good deal. The federal government will pay 100% through 2016 and phase down to 90 percent by 2020. The state senate supports it and the governor said that “in good conscience,” he can’t block it. Passage of such a bill could brighten many lives in the Sunshine State.
We’ll see you in Tallahassee for Tally Days.
Blue Skies!
Sandra McClinton
Cape Coral