Avalere Health now says it expects that a slight majority of states will say no to federal funds for Medicaid expansion under the Affordable Care Act.
Florida, which had been marked "leaning yes" on the Avalere Map after Gov. Rick Scott said he favored the idea, has now been marked "leaning no."
The Legislature is scheduled to end its session Friday with the House still refusing to accept federal funds. Unless Scott calls a special session and the House has a change of heart, it appears Florida will miss out on at least $1 billion it could have collected for 2014.
The Legislature could change its mind in some future year, but would not get back the money it missed for 2014.
As The Washington Postreports, at least three other states -- Ohio, Arizona and Michigan -- are in the same position as Florida, with legislators resisting money that governors are willing to take.
As part of the Affordable Care Act, federal funds that are available to Florida over a 10-year period are an estimated $51 billion. The money would be used to cover an estimated 1.1 or 1.2 million uninsured people, mostly low-income working adults who either don't get employer coverage or can't afford it.
If all the states had participated in Medicaid expansion, Avalere projected that the program would have grown by 10.7 million next year. But with 26 states opting out, the projected enrollment expansion is forecast at 5.5 million.
The Supreme Court ruled last year that the federal government could not compel the states to comply with Medicaid expansion, since the program is jointly run.