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'No' on Expansion Costs Business

The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

The decision by state lawmakers not to expand Medicaid could cost Florida businesses as much as $253 million a year in tax penalties, according to a new report released Wednesday.

Companies with 50 or more employees face Internal Revenue Service penalties if workers get subsidized health insurance through the new exchange under the Affordable Care Act. But they face no penalty if workers get subsidized coverage through Medicaid.

A report by Jackson Hewitt Tax Service Inc. estimates that 214,000 Floridians between the ages of 18 and 64 are uninsured, work full time and earn a figure somewhere between the poverty line and 138 percent of poverty.

Of those, about 84,000 work full time for large companies offering health coverage, but workers likely can’t afford it and could seek coverage and get tax credits in the exchange.

That could cost Florida businesses between $169 million and $253 million a year, assuming a penalty between $2,000 and $3,000 for each employee who gets a subsidy in the exchange, according to the report.

If Florida lawmakers had agreed to expand Medicaid, employers wouldn’t be facing a tax penalty because the workers would qualify for Medicaid. Its expansion would cover low-income people making up to 138 percent of the federal poverty level, or about $15,860 for an individual.

“As some states are still evaluating their participation, it is critical that any projections of the ‘net’ costs of Medicaid expansions also reflect the very real costs of the shared-responsibility penalties to employers in any particular state,” said Brian Haile, senior vice president, Jackson Hewitt Tax Service Inc.

Democrats and health advocates have been trying to build momentum on Medicaid expansion, but it may be a stalled issue even before the 2014 Legislative session begins in a few months.

Sen. Rene Garcia, R-Hialeah, filed a Medicaid expansion bill Tuesday similar to one that passed the state Senate last year but died in the House.

“As one of the nation’s largest economies, it would be irresponsible to leave money that can benefit thousands of Floridians on the table,” Garcia said. “This bill would provide a vital economic impact through increased coverage in Medicaid statewide and potential job growth.”

The Obama administration has promised states it will pay for 100 percent of the expanded program over the first three years, and 90 percent after that.

Florida’s current Medicaid eligibility cutoffs are among the stingiest in the country and do not include coverage options for childless adults. Officials estimate more than a million Floridians would be eligible for coverage under an expanded Medicaid.

Last year, Senate leaders crafted a compromise that would draw down more than $50 billion in federal funds and give it to residents so they could buy private insurance. But the House did not want to take any funds tied to the Affordable Care Act.

Republican House Speaker Will Weatherford was the driving force behind that decision. And in a recent editorial, he revealed that he hasn’t changed his mind.

Weatherford told The Florida Times-Union last month that Medicaid is a flawed system that doesn’t help the poor, and echoed concerns from fellow conservatives that the federal government would not keep its promise to foot the bill. “The Florida House stood for providing a common-sense, quality solution to address our health care challenges,” Weatherford wrote.

Much of the discussion supporting Medicaid expansion last year came from Democrats and health advocates. But proponents hope enlisting the business community will get the attention of key Republicans including Gov. Rick Scott, whose campaign centers on creating jobs and stimulating the economy.

Scott made an about-face decision last year supporting Medicaid but it wasn’t a priority during the last session, and he has given no indication it will be one going forward.

“This is the largest economic stimulus opportunity that the state of Florida has had in decades, and right now we only have one person that’s saying no,” said Deirdre Macnab, state president of the League of Women Voters of Florida, in reference to Weatherford.

Her group has launched a campaign to educate business leaders, and cultivate allies among local chambers of commerce, across the state.

“That’s why we’ve enlisted the business community, because they are a very important voice in the state,” Macnab said. “They understand the power of an investment and good health has on their employees of the competitiveness of our state.”