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Dueling presentations on FHIX plan show merits of health expansion all in the eye of beholder

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Healthcare committees in the House and Senate on Monday discussed the same proposal to expand healthcare access to the uninsured–SB 2A–in Florida. But it might not have sounded like it.

In a “Tale of Two Cities”-esque tableau, the Senate discussed the bill for one hour before unanimously agreeing to pass it with sponsor and Health Care Policy Committee Chairman state Sen. Aaron Bean answering members’ questions. The House of Representatives discussed the measure for three hours but never took a vote.

The contrast was heightened by the fact that neither chamber took any testimony from the public at its hearings with committee chairman state Rep. Jason Brodeur preferring to have the members ask as many questions they wanted and former Senate President Don Gaetz leading Chair Bean through a list of tough but leading questions, in the manner of a defense attorney shepherding a coached witness.

Gaetz went through a list of questions he said he had picked up during his customary “neighborhood days,” amid reports he may soon run for the U.S. House, during which he learns his constituents’ concerns and transcribes them.

In addition to showing an elaborate slideshow — unlike the Senate, which simply referred technical questions to their senior policy advisor on health, Carol Gormley — the House included data in the committee package that showed the cost impact of the new version of the FHIX program, dubbed “FHIX 2.0” and “FHIX Remix” and how much the program would cost if the federal government changed the contribution requirement. The expansion is fully compensated through 2016 and effective 2017 the federal government will cover 90 percent of the costs.

The Senate bill makes clear that the program would be eliminated if funding fell under 90 percent. But information included in the House package at the behest of state Rep. Brodeur shows that Florida would be on the hook for nearly $720 million in 10 years if the funding were to drop to traditional Medicaid match, or 60 percent federal match and 40 percent state funding. Florida would be on the hook for nearly $148 million if the federal government paid 85 percent of the costs.

The Senate Majority Office reiterated on Twitter the cut-off if funding fell below 90 percent but House member state Rep. Cary Pigman asked how effective a “sunset” provision would be and whether it could stand up to a legal challenge. House staff chose not to “speculate” on whether eliminating the program would stand up to a legal challenge, and instead answered by suggesting that the better question may be whether the Legislature would want to eliminate the program if funding fell below 90 percent.

State Sen. Rene Garcia, an outspoken supporter of the FHIX plan, was less coy about another hypothetical — the possible loss for more than a million Floridians of federal health subsidies through the Affordable Care Act, given an adverse decision in King v. Burwell.

If that happens, Garcia said: “We’ll be back here next session trying to figure out a way to fix it.”

In the Senate meeting, the concerns that Gaetz walked through were whether illegal immigrants might improperly receive benefits through the FHIX plan; just how tough the plan’s work requirements are; the old question of universal “skin in the game,” or universal payments in exchange for care, even among the indigent; and disincentives for the newly insured going to the emergency room.

Bean’s answers to Gaetz’s questions were generally, “That is my understanding, yes.”

Ultimately, both houses gave the bill something of a kayfabe, show-trial treatment.

Asked by the Tampa Tribune’s Jim Rosica about the fact that many observers feel the outcomes in both chambers are pre-scripted and not subject to genuine change, Brodeur did his best to refrain from breaking the fourth wall between performer and audience.

“It seems like the outcome is predetermined,” remarked Rosica.

“OK,” said Brodeur, breaking into a broad smirk.

Staff writer Christine Jordan Sexton contributed to this story.

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Ryan Ray writes about campaigns and public policy in Tampa Bay and across the state. A contributor to FloridaPolitics.com and before that, The Florida Squeeze, he covers the Legislature as a member of the Florida Capitol Press Corps and has worked as a staffer on several campaigns. He can be reached at ryan@floridapolitics.com.

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