Florida Legislature Refuses To Extend Medicaid Coverage To One Million Low-Income People

By Tara Culp-Ressler on May 6, 2013 at 9:00 am

Florida Gov. Rick Scott (R)

Florida Gov. Rick Scott (R), an ardent Obamacare opponent, surprised health care reform advocates earlier this year when he endorsed expanding his state’s Medicaid program. But the governor can’t single-handedly add more low-income residents to the Florida’s Medicaid rolls; the proposal still needs the support of the GOP-controlled legislature, which has been fighting over itfor the past several months. And now that the state’s legislative session has come to an end, time has run out for the estimated 1.3 million Floridians who stood to gain health insurance under Obamacare’s Medicaid expansion.

On Friday, the legislature concluded without passing a budget that includes funding for expanding Medicaid. That means Florida won’t expand Medicaid in 2014 unless lawmakers convene a special session sometime later this year. Democrats in the state are calling for that special session to focus on pushing through a compromise, but the Republican-dominated legislature may not comply. The decision to refuse the expansion will leave about one million Florida residents uninsured.

As Wonkblog’s Sarah Kliff notes, this situation isn’t unique to Florida. In other red states, the Republican governors who have chosen to endorse Medicaid expansion are also struggling to get the support they need from the other members of their party to advance the policy:

This isn’t a phenomenon reserved to Florida. In Ohio, Gov. John Kasich (R) is having trouble moving the Medicaid expansion he supported through the state’s Republican controlled-legislature. Similar fights are playing out in Arizona and Michigan, where Republican governors find themselves in the relatively odd position of trying to sell Obamacare to state legislators of their own party.

In a way, this is a bit surprising. No one ever expected to hear Scott extoll the benefits of President Obama’s signature legislative accomplishment. That being said, the Medicaid expansion is a really big deal for state budgets — the budget that Scott is charged with overseeing. If his state had participated in the Medicaid expansion, the Urban Institute estimated it would bring $66 billion of federal funds into the state over the course of a decade.

That same burden doesn’t rest so heavy on state legislators. States and hospitals tend to cover much of the country’s uncompensated care and unpaid medical bills. Meanwhile, state legislators have faced intense pressure over this vote. In Ohio, my colleague Sandhya Somashekar reported on one group that went door-to-door collecting signatures from voters pledging to thwart reelection efforts should lawmakers there vote to expand Medicaid.

The politicized in-fighting over Obamacare has pitted governors against legislatures across the country, as many Republicans still refuse to cooperate with health reform no matter what the cost. But for the residents in states like Florida, that political reality comes with especially significant consequences.

Florida, where about one in five people lack health care, has one of the highest rates of uninsurance in the nation. Previous studies have estimated that it’s one of the states that would benefit the most from the health reform law’s Medicaid expansion provision. Hospital groups and faith leaders in the state have both lobbied for expanding Medicaid, which they characterize as a “pro-life” program. Nevertheless, even though Rick Scott was able to put aside politics to prioritize health care for low-income Floridians, his fellow Republican lawmakers haven’t been able to do the same.

Thank you to Think Progress for this story.

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