A recent deal with CMS would bring $1 billion to safety-net hospitals for fiscal year 2016, but Medicaid expansion to 800,000 Floridians is worth an estimated $2.1 billion.
While an agreement with CMS has offered breathing room to care for the uninsured, Florida’s hospitals and some lawmakers haven’t given up on Medicaid expansion before the state completes its budget this month.
On Wednesday, the Florida Senate voted 33-3 to approve an Arkansas-style expansion-plan that would let Floridians earning between 100% and 138% of the federal poverty line use premium credits to buy coverage on the Florida Health Insurance Exchange, for FHIX. The Florida House of Representatives, however, has been less enthusiastic, and it is doubtful that Governor Rick Scott would sign legislation if it reached him.
House Republicans debated the plan Thursday in a tense session that took place while hospital employees who came to Tallahassee demonstrated in favor of expansion. The House seems unlikely to approve the bill in a vote scheduled today, something that did not please the healthcare workers who talked to reporters.
“I feel strongly that healthcare should be accessible to all people—it shouldn’t be just for those who cannot totally afford it, or those who can afford health insurance,” said Maureen Hovey, an assistant nurse manager at Florida Hospital. “We need to make sure we have coverage for everyone in our community.”
The urgency of Medicaid expansion has passed with the May 21, 2015, announcement that CMS will provide some funds for Florida’s Low-Income Pool, the program that pays for uncompensated hospital care. That program had been scheduled to expire June 30, 2015, and the impasse had threatened to shut down the government. But CMS blinked, and determined that the state qualified for $1 billion for fiscal year 2016.
However, the pool will only be eligible for $600 million in fiscal year 2017; by contrast, expanding Medicaid to 800,000 Floridians would bring $2.1 billion to the state, and to many hospital leaders, that’s a better deal.
Conservative lawmakers opposed to expansion don’t agree, however. While the federal government pays 90% of expansion costs, opponents of the move say Florida cannot afford the final 10%.