In a series of tweets on Sunday, Florida House Budget Chairman Richard Corcoran laid bare what’s been a fact all legislative session in Tallahassee –that he and his GOP House colleagues are not going to buckle under and accept the Florida Senate’s plan to propose a version of Medicaid expansion.
Such a plan could allow up to 800,000 Floridians with an income of up to 138 percent of the federal poverty level to get on a private insurance plan by accepting the federal government’s offer to expand Medicaid coverage.
“Who are the 607K that we’re so willing to deny the 609K hard working Floridians from their private insurance,” went one tweet. Another was, “Taking private insurance with great outcomes from 609k Floridians to give 607K Florida medicaid is not a fix. It’s disgraceful.”
Presumably Corcoran is referring to Floridians who currently are eligible and receiving Medicaid benefits under the Affordable Care Act. The majority of those are children, though a small number of uninsured adult parents are also receiving benefits.
But Joan Alker, a co-executive director of the Center on Children and Families at Georgetown University who studies health policy, says what Corcoran is alleging is not completely accurate.
She said it’s true that if the state were to accept the feds’ plan to expand Medicaid, those currently receiving some benefits through the Affordable Care Act would lose their right to tax subsidies that they currently enjoy. But she said it was absolutely not true that they would lose the coverage they’re currently getting through the federal marketplace.
She said Florida could design its own solution and use Medicaid funding to purchase qualified health plan coverage through the marketplace as both Iowa and Arkansas have received federal approval to do.
“Under this scenario, these Floridians would retain their current insurance, and have better cost-sharing protections that are better associated with being Medicaid beneficiaries,” she said on a conference call organized by the Florida League of Women Voters, a strong proponent of Medicaid expansion.
Corcoran and other House members for years have criticized Medicaid as being an inefficient healthcare delivery system, with some going as far to cite a 2010 University of Virginia study that purportedly found that Medicaid patients were 97 percent more likely to die than those with private insurance. However, PolitiFact reported last week that Corcoran was citing a study that looked at Medicaid patients who underwent surgery, not all people in the program, and gave him a “Mostly False” grade.
Georgetown University Professor Joan Alker called the criticism of Medicaid “so preposterous that it’s a shame to have to spend time refuting it,” and cited other studies that prove just the opposite.
She said that having Medicaid coverage puts an immediate end to the “stress and economic vulnerability” that comes from being uninsured, and added this kicker, saying, “It’s unlikely that legislators opposing expansion would subject their own families to this level of financial risk by going without their own state- provided health insurance.”
Meanwhile, the two legislative bodies are contending with how to deal with the potential loss of $1.3 billion in federal Medicaid funds from the so-called LIP (Low Income Pool). Going back to 2006, Florida secured a waiver from the Bush administration that would allocate additional funds to help cover the costs of treating uninsured patients. As Professor Alker explained, this was not for health insurance, but a waiver the state received for funding to ease the transition to statewide managed-care by making payments to providers for uninsured and underinsured.
In 2011, the Obama administration allowed Florida to extend the program for an additional three years after the state lifted caps on annual benefits. But in 2014, the White House renewed LIP funding only for an addition year — ending on June 30, 2015, and informed the state that it would need to overhaul the program to get any more money in the future. Now the feds say that unless the state expands Medicaid, they definitely won’t get the $1.3 billion, which has led Gov. Rick Scott to sue the administration.
All indications are that the Legislature will not come to an agreement this session on a budget, and will plan a special session to deal with the Medicaid funding issue next month. But if Budget Chairman Corcoran’s sentiments remain consistent, there seems no way out of the current situation — without someone blinking.