Despite testimony urging them to be wary of tapping into any increased Medicaid dollars, the Senate Appropriations Subcommittee on Health and Human Services on Tuesday passed its Medicaid expansion bill that would provide coverage to an estimated 800,000 uninsured Floridians.
Though the committee had been given three hours to debate and discuss SB 7044, sponsored by state Sen. Aaron Bean, it moved the bill in less than one hour. It passed unanimously despite opposition from Americans for Prosperity as well as the National Federation of Independent Business, Florida.
Americans for Prosperity lobbyist Skylar Zander warned against using federal dollars for healthcare and said healthcare was a state’s rights issue. Zander warned the committee that a bureaucrat in Washington, D.C., could abruptly change the rules, which would force the state to redraft its health proposal.
State Sen. Joseph Abruzzo questioned whether Zander was aware of all the federal matching funds in Florida’s budget in areas like transportation and education in addition to healthcare.
“I’m very aware,” he replied. “And that does not mean that I believe in those programs, either.”
NFIB Florida Executive Director Bill Herrle–whose group was behind the first Supreme Court of the United States challenge of the federal healthcare law–said the state should not move ahead with an expansion for fear of losing Low Income Pool dollars. LIP is a $2 billion plus pool of supplemental Medicaid dollars the state uses to fund uninsured and underinsured. It goes mostly to hospitals but also is used for federally qualified health centers, graduate medical education and even prepaid health plans. The federal government advised Florida last year that LIP would not be expanded beyond June 30, 2015. Now the Legislature is scrambling to replace LIP or build a budget without the money.
Though the SCOTUS found the health law constitutional the court did rule that the federal government couldn’t withhold Medicaid dollars to states that didn’t expand Medicaid to working uninsured. Herrle urged the Legislature to “stand up to this and reject this Medicaid expansion when it’s being done under this duress.”
Herrle said his group supported direct patient care–which is being pursued in the House–and even would support Florida using state revenue to help provide healthcare to Floridians.
Committee chairman state Sen. Rene Garcia chided Herrle for supporting Florida dollars for healthcare but not federal dollars.
“You’re asking taxpayers of Florida to be double taxed in order to receive healthcare?” Garcia asked Herrle.
Not all the opposition came from the audience. There were rumblings from some of the Democrats on the committee with some of the provisions in the bill. Those concerns ranged from cost-sharing requirements that would be placed on poor Floridians to some of the educational and work requirements that would apply to those who enrolled in the program.
Other concerns centered around the Agency for Health Care Administration’s oversight over the Medicaid expansion and why the little known Florida Health Choices Program would administer the program and not the more well known Florida Healthy Kids Corp.
State Sen. Eleanor Sobel had six amendments that would have addressed all the Democrat’s concerns but she withdrew them.
State Sen. Joseph Abruzzo told Bean that if the bill were in its final form on the Senate floor he couldn’t support it and wanted to see some of the amendments Sobel withdrew eventually be included in the Senate measure.
Abruzzo also said he had “issues” with opponents arguing against the bill because Florida would rely on federal Medicaid dollars to provide the insurance. He noted that the majority of the state’s budget is comprised of federal dollars.
“Without the federal government, we would have a Mad Max Florida. It would be out of control,” Abruzzo said, adding the federal government is Florida’s partner. “We are America. That’s what it’s all about.”