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Expanded Medicaid's Time May Have Come At Last, Miami-Dade Legisators Say

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The stars seem to be aligning for Medicaid expansion in the Florida Legislature this year.  After two years of blunt refusals to even consider it, some top Republicans, like Miami State Sen. Anitere Flores are saying the time has come.

"And what's interesting," Flores said after a Monday  interview with the Miami Herald editorial board, "is that you have the buy-in from the business community, from the private sector, from your nontraditional supporters of government funding."

The business community has contributed two major players to the Medicaid plan. Associated Industries of Florida and the Florida Chamber of Commerce have each submitted Medicaid proposals for the Legislature to consider during the session that begins March 3. Each  would extend federally-funded health coverage to about a million Floridians who are too poor to qualify for policies under the Affordable Care Act, yet earn too much to get their care from Medicaid.

But plans come with work requirements and required monthly premiums. Democratic State Sen. Oscar Braynon, who represents South Broward and North Miami-Dade, says those would be hard to swallow. 

"The premiums, some of the work requirements, all those things I have some hesitation with. But I'm just trying to get them to swallow the pill,  just in general, right now," Braynon said.

But those requirements may not make it to the final product. Similar obligations in Medicaid proposals considered in Arkansas, Iowa, Michigan and Pennsylvania were disallowed by the Centers for Medicare and Medicaid Services, the federal agency that oversees Medicaid.

The federal government is supposed to pay 100 percent of the cost of expanding Medicaid through 2016 with the state's share rising gradually thereafter to 10 percent by 2020. Republicans have said they worry that the feds will renege and pass the entire bill on to Florida.