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Why Florida Lawmakers Are Now Considering Medicaid Expansion

Rene Garcia_2.jpg
Sammy Mack

When Florida sued to overturn the Affordable Care Act, lawmakers targeted a piece of the law that would have forced Florida to make Medicaid available to more than a million uninsured Floridians.

The U. S. Supreme Court upheld most of the act but it made Medicaid expansion optional.

Now some Florida lawmakers who originally opposed Medicaid expansion are seriously considering that option.

A recent poll showed that nearly two thirds of Floridians are in favor of expanding Medicaid. Research from Georgetown University’s Health Policy Institute and the Jesse Ball duPont Fund suggests Medicaid expansion could save Florida up to $100 million a year in health costs.

“I can say that I’ve moved from a position where I was totally against it to a position that I would consider it and think about it,” said State Sen. René García, a Republican from Hialeah, who was in Miami on Monday for a legislative forum on Medicaid expansion. García still has reservations about the cost of the expansion but he says he's more open to it now.

García was one of the partners on the forum, which was hosted by The Health Foundation of South Florida, the Health Council of South Florida and United Way of Miami-Dade to discuss the economic impact of Medicaid expansion.

You can listen to García’s conversation with WLRN health reporter Sammy Mack about what’s changing his mind in the player above. And you can find more background and resources to understand Medicaid expansion in Florida here:

Legislative Analysts Told Scott His Medicaid Estimates Are Wrong (But He's Using Them Anyway)

Our partners at HealthNewsFlorida.org and WUSF learned that Gov. Rick Scott’s office had been intentionally using substantial over-estimates of the cost of Medicaid expansion while arguing against it:

Scott says he opposes expanding Florida Medicaid because it would cost too much: $63 billion over 10 years, he says, with the state paying $26 billion of that. … A series of e-mails obtained by Health News Florida shows the analysts warned Scott’s office the numbers were wrong weeks ago, but he is still using them. He cited them in a Tampa Bay Times op-ed on Sunday and at a Washington press conference on Monday.

After the story was published, Florida released a revised projection that estimates Florida would spend about $3 billion to expand Medicaid over 10 years.

Florida’s Medicaid Choice: Understanding Implications of Supreme Court Ruling on Affordable Health Care Act

This study from the Health Policy Institute at Georgetown University and the Jesse Ball DuPont Fund outlines the projected impact of expanding Medicaid in Florida:

» An estimated 800,000 to 1,295,000 uninsured adults and children in Florida will gain coverage if the state moves forward. » The state can expand coverage without assuming any new net costs by achieving savings in other areas of the state’s budget. In fact, overall state costs are likely to be reduced by some $100 million annually because some safety net programs will become less necessary. » If the state does not expand coverage, Florida's hospitals will lose federal revenue without offsetting gains in coverage for their patients.

The Cost and Coverage Implications of the ACA Medicaid Expansion: National and State-by-State Analysis

A super wonky—but very thorough—breakdown of state-by state cost estimates. Produced by the Kaiser Family Foundation and the Urban Institute, the report clearly lays out the funding structure built into the Affordable Care Act:

The analysis shows that the impact of the ACA Medicaid expansion will vary across states based on current coverage levels and the number of uninsured.  It also shows that by implementing the Medicaid expansion with other provisions of the ACA, states could significantly reduce the number of uninsured.  Overall state costs of implementing the Medicaid expansion would be modest compared to increases in federal funds, and many states are likely to see small net budget gains.