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Medicaid Grows Without 'Expansion' $

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

Even though Florida’s Legislature turned down federal funds to expand Medicaid under the Affordable Care Act, leaving billions of federal dollars on the table, the state's health insurance program for the poor continues to grow.

Florida’s Medicaid program added about 165,000 people in October, according to a report from the Centers for Medicare & Medicaid Services. The growth exceeded that of any other state -- including those that voted to accept federal funds to expand their Medicaid programs.

The flow of federal funds to the states that voted to expand the program is set to begin Jan. 1. In Florida, the expansion would have affected about 800,000 people -- mostly adults -- who have incomes below the poverty level but still don't qualify under Florida's rules.

The state Agency for Health Care Administration has long predicted Medicaid will grow because of the "woodwork effect" -- uninsured people who already qualified for the program stepping forward to enroll because of heightened publicity about the requirement for health coverage under the Affordable Care Act.

Many uninsured people may have heard that there is a financial penalty for going without coverage after March 31. Those with low incomes may not know they are exempt from the requirement.

The "Get Enrolled America" campaign waged by volunteers has been raising awareness in low-income neighborhoods around the state, encouraging people to check with their local health centers. Those centers' application counselors and navigators are mainly there to help the uninsured enroll in a plan at, but if they find someone who qualifies for Medicaid they guide them toward that program.

Altogether, about 1.5 million children and adults nationwide were added to state Medicaid programs in October, the report says. Kaiser Health News has more information on the nationwide results.

During the spring legislative session, after Gov. Rick Scott said he supported taking the federal funds for Medicaid expansion to about 1 million Floridians, state Sen. Joe Negron came up with a bill that passed easily. It would  have tapped the federal funds -- estimated at $51 billion over 10 years -- to provide uninsured adults under the poverty level with coverage through private insurers. But House Speaker Will Weatherford said no, and all but one of the Republicans voted it down.

The Florida Currentreported Tuesday that Negron has no hope that the Legislature will resurrect Medicaid expansion in the 2014 session. And that could remain true for 2015-16. State Rep. Steve Crisafulli, who will become Speaker in late 2014 for the next two years, has also ruled out Medicaid expansion.

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

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.