Medicaid Ballot Drive Could Be Delayed

Jul 24, 2019

A drive to expand Medicaid in Florida may be pushed back two years, as organizers try to figure out if they can muster the resources to put the issue on the 2020 ballot.

A spokesman for a political committee backing a proposed constitutional amendment --- which comes after years of Florida lawmakers rejecting Medicaid expansion --- said a final decision has not been made, but he acknowledged it may be difficult to meet state-imposed deadlines to take the issue to voters in 2020.

The committee, Florida Decides Healthcare, Inc., has “not made a decision about whether we have the resources and the time to.be on the ballot in 2020,” said spokesman Dan Newman, who stressed that the proposed amendment isn’t being withdrawn. “It’s more of a pacing question than it is about stopping or starting.”

If organizers wait until 2022, it could thrust Medicaid expansion into the heat of that year’s governor’s race. Republican Gov. Ron DeSantis, who would be up for re-election in 2022, is firmly against expansion and the federal Affordable Care Act, which allows states to expand who’s eligible for Medicaid coverage.

To make the 2020 ballot, backers of the proposed amendment would need to provide at least 766,200 valid petition signatures to the state.

According to the state Division of Elections website, Florida Decides Healthcare had 79,233 valid signatures as of Wednesday afternoon, enough to trigger a review by state economists of the proposal’s potential financial impact and a Florida Supreme Court review of the proposed ballot wording.

Getting an amendment on the ballot can cost millions of dollars. Between January and June, Florida Decides Healthcare received $546,535 in contributions, which were listed in records as “in-kind” contributions. The majority came from The Fairness Project, a Washington, D.C.-based group that has contributed nearly $380,000 according to the state records.

The Fairness Project supports campaigns to increase access to health care and raise state minimum wage laws. 

Attempts to contact the group Wednesday were unsuccessful.

“It’s a pretty dynamic environment,” Newman said. “It’s not solely based on Florida politics but how things are going nationally and how other programs and opportunities they have (in other states) are moving.”

State economists are scheduled Monday to hold the third of four meetings to determine how much Medicaid expansion would cost the state. 

Economists earlier this month agreed that roughly 260,000 people would enroll if the state expanded Medicaid access to low-income adults who are currently not eligible. But the economists haven’t finalized what the potential costs --- or savings --- would be to the state budget.

An increased economic review was mandated this year by the Legislature, which included the requirement in a newly enacted law (HB 5). The law also includes changes that are widely expected to make it more difficult to gather petition signatures to place initiatives on the ballot.

Medicaid is funded jointly by the state and federal governments. It traditionally has covered low-income women and children and seniors. The federal government generally pays about 60 percent of the costs of the program and the state absorbs the other 40 percent.

But the Affordable Care Act, better known as Obamacare, expanded Medicaid to cover low-income uninsured adults who don’t have children. Also, the federal government agreed to pay 90 percent of the costs of expansion.

Thirty-six states and the District of Columbia have expanded Medicaid access to childless adults as allowed under Obamacare, according to Families USA. The Republican-led Florida Legislature though, has been steadfast in its opposition to a Medicaid expansion since the federal health law passed.

The proposed constitutional amendment could allow supporters to take the issue directly to voters and effectively bypass the Legislature.

State Sen.Lori Berman, a Lantana Democrat who has supported expansion, told The News Service of Florida on Wednesday that she is disappointed that the proposed amendment may be delayed.

“I wanted it to be on the ballot because I believe Florida should have had a Medicaid expansion from the beginning under the Affordable Care Act,” said Berman, who is vice-chairwoman of the Senate Health Policy Committee. “This means the uninsured people in Florida will continue to lack health care for a longer period of time.”