FMA Supports Medicaid Expansion

Jul 28, 2014

  The Florida Medical Association's House of Delegates overwhelmingly adopted a resolution supporting Medicaid expansion to cover uninsured low-income adults at FMA's annual meeting on Sunday, according  to doctors who were there.

Dr. Aaron Elkin
Credit DrElkinMD.com

(Editor's note: This story has been updated with the statement from FMA.)

FMA issued a statement on Monday, quoting General Counsel Jeff Scott, confirming passage of the resolution but adding that support for Medicaid expansion is contingent on the state providing enough pay for doctors who treat Medicaid patients to make such care possible.

The resolution calls for "parity," in which Medicaid pay for doctors would be at least equal to that of Medicare.

Medicaid expansion, an optional part of the Affordable Care Act, would address the problems faced by  approximately 800,000 Floridians who are in the "Medicaid Gap." They don't qualify for Florida's traditional Medicaid program -- which leaves out adults who have no children at home, regardless of income -- but earn too little to qualify for subsidies on the new federal Health Insurance Marketplace.

The resolution, authored by Dr. Aaron Elkin, a Hollywood obstetrician-gynecologist, was sponsored by the medical societies of Broward, Miami-Dade and Palm Beach counties, according to the FMA statement.

The health law makes money available to the states to expand coverage to those in the gap -- 100 percent funding through 2016, then tapering to 90 percent after 2020. Health economists have estimated that $51 billion in federal money was available to Florida over a 10-year period for Medicaid expansion beginning in January 2014. But each year of delay reduces the amount available.

In 2013, the Florida Senate passed a bill that would have accepted the funds to cover the low-income uninsured if the federal government allowed the state to enroll the patients in private plans -- a rollout that is already under way for other state Medicaid beneficiaries.

Gov. Rick Scott, who had opposed other matters related to the Affordable Care Act, said he would accept the expanded coverage to the poor. But it was blocked in the Florida House by Speaker Will Weatherford and other Tea Party Republicans.

So when the Medicaid expansion money began to flow to other states in January, Florida was omitted. In this year's legislative session, neither House nor Senate took up bills on Medicaid expansion.

At FMA's annual meeting last year, a resolution supporting Medicaid expansion was referred to a  committee for further study, which killed it for the year. It placed FMA out of step with the American Medical Association, which actively supported the health law and expansion of coverage to the poor.

While FMA did not publicly state why it took  no action last year, those who attended committee meetings said officers were worried that if they pushed the issue and made Weatherford angry, the doctors would be punished on other issues that mattered to them.

The three doctors who verified Sunday's passage are members of Doctors for America.  Dr. Mona Mangat, an allergist-immunologist in St. Petersburg who serves as state director for the group, released a statement Monday morning applauding the FMA action.

"The Florida Medical Association sent a resounding message about the importance of increasing access to health care for nearly 1 million Floridians. Doctors across Florida are united in expanding access to care because we know this is the right move for our patients and our state.

"We applaud the FMA for this vote and look forward to working together in the upcoming legislative session" in January 2015, she said. She said 2,200 Floridians will die this year for lack of access to health care -- people like Charlene Dill, whose death was described in Orlando Weekly in April.

--Health News Florida is part of WUSF Public Media. Contact Editor Carol Gentry at 813-974-8629 (desk) or e-mail at cgentry@wusf.org. For more health news, visit HealthNewsFlorida.org.