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Failure to Act Leaves Employers on Hook

In an article published late last month, Health News Florida noted a warning from a tax expert who said Florida employers would pay a high price if the Florida Legislature failed to adopt Medicaid expansion.

Now the legislative session is over, without action on the expansion. Come Jan. 1, if nothing happens meanwhile to intervene, the state's businesses will find out whether Jackson Hewitt's Brian Haile was right.

He noted that if the Florida Legislature failed to accept federal funds to expand Medicaid under the Affordable Care Act, businesses with more than 50 employees that don't cover their workers could end up paying tax penalties of $2,000 to $3,000 per employee.  He calculated that such penalties could cost employers in the state $145.7 million per year.

The Tampa Bay Times  reported Sunday on the Haile warning as well as another phenomenon: By saying no to expanded Medicaid, the Legislature leaves U.S. citizens in Florida without coverage while non-citizens in the state legally will be able to qualify for subsidized coverage.

Of the state's uninsured, who have been estimated at between 3.5 million and 4 million, all but about 1 million would have been eligible for coverage in 2014 either through tax credits for insurance purchased through the exchange (both small businesses and individuals can qualify) or through Medicaid expansion.

However, without Medicaid expansion, the number of uninsured remaining in Florida could be closer to 2 million. And the people getting subsidies for coverage will be those who earn over the federal poverty line, not those under it.

Over the weekend, thestate's newspapers denounced the Legislature's failure to take advantage of a rare opportunity to get help to those who need it without additional state taxpayer dollars. The Miami Herald called it "the triumph of toxic politics over common sense."

The Tampa Bay Times listed many corporations that got breaks from the Legislature. "The contrast is striking between the voices who are heard in Tallahassee and those who aren't," the editorial said.

But the leaders of the Senate and House seemed unfazed by the criticism. As the Palm Beach Post reported, Senate President Don Gaetz said that instead of lobbying lawmakers to adopt the expansion in a special session, business interests should lobby the federal government to give states more flexibility in how many of the uninsured to cover and how to do it.

And House Speaker Will Weatherford, who led the resistance to accepting federal funds, said he thought the business community was happy with the Legislature's performance. As the Post reported, he said the business community is getting what it wants -- a "predictable business climate, low taxes and a great education system."

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.