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Affordable Care Act

It's Senate Panel's Turn on Medicaid Expansion

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On Monday, a panel of state senators who have put months of study into the Patient Protection and Affordable Care Act will be asked to vote on the most contentious issue of the session: Should Florida accept federal funds to expand Medicaid coverage to low-income adults?

The Select Committee on PPACA, chaired by Sen. Joe Negron, convenes at 1 in a meeting that will be webcast on TheFloridaChannel.org.

Given that the companion committee in the House voted down the Medicaid expansion idea on a straight party-line vote last Monday, some might wonder: Why bother?  As the Florida Current reported, Senate President Don Gaetz told reporters the House seemed dug in on its position so it might be pointless for the Senate to spend much time on it.

But others, including Rep. Janet Cruz, D-Tampa, said the vote may just be "early session posturing" and that things can change as the session progresses, the Tampa Tribune reported.

Meanwhile, as the Times/Herald Bureau reports, the Florida Chamber of Commerce followed Gov. Rick Scott's example and said it endorses Medicaid expansion -- with conditions. The Chamber's conditions include passage of some bills that have little or nothing to do with Medicaid expansion, such as tort reform and limits on doctors' dispensing of drugs in workers' compensation.

Scott's conditions were that the approval be reversed if the federal government reneges on its offer of 100  percent funding for the first three years, and that the approval "sunset" in three years, requiring a renewal to proceed.

In 2016, according to the Medicaid expansion section of the health law -- which the U.S. Supreme Court said can't be mandatory, but must be a voluntary decision by each state -- the federal percentage of the cost of coverage will begin to drop until it reaches 90 percent in 2022 and remains at that level.

But the Republican members of the House committee said they don't believe the federal government will come through with the money, given the cost-cutting discussions going on in Washington, D.C.  Also, they expressed reluctance to expand what some called an "entitlement" program.

Members of the committee, chaired by Rep. Richard Corcoran, R-Lutz, said they aren't heartless, that they care about the uninsured. They said they'd prefer an alternative plan, such as the one Arkansas got federal approval to try, which lets the Medicaid expansion funds be used for private plans through the health exchange.

The committee took its lead from House Speaker Will Weatherford, R-Wesley Chapel. But in his attempt to explain his opposition to Medicaid expansion, Weatherford told a personal anecdote about his family that came back to bite him by week's end.

Weatherford's opposition to the Medicaid expansion may end up helping Gov. Scott in his coming re-election, writes Tampa Bay Times Political Editor Adam Smith. That's because Scott gets to look compassionate -- or at least pragmatic -- to the voters at large by saying he's willing to accept the federal funds to cover the uninsured. While the Tea Party is furious at him, the House can stop the expansion and defuse the issue.

Last week, as Health News Florida reported, Chief State Economist Amy Baker told both committees in joint session that Florida needs to accept the federal funds for Medicaid expansion in order to offset other costs associated with the health law, such as the tax on health insurers.

Her research team's latest calculations on the cost and benefit of Medicaid expansion are that it would cover about 900,000 Floridians, cost Florida $3.5 billion over a decade and bring more than $51 billion in federal funds to the state over the same period.