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Speaker Ignores Editorial Chorus on Medicaid

Weatherford.jpg

Editorial boards at the Tampa  Bay Times and The Tampa Tribune don't agree on much beyond motherhood and apple pie, with the Times leaning left and Trib leaning right. But there’s one thing they do agree on: Florida should take the money.

The money in question is the Affordable Care Act's Medicaid-expansion funds. There is enough money sitting in Washington for Florida to  cover the entire cost of covering nearly 1 million uninsured poor people through 2016 and  at least 90 percent thereafter. It amounts to billions of dollars a year.

And it's not retroactive. So if Florida misses the money available in 2014, it could tap money in later years, but the 2014 money will be gone. History.

The people who would gain coverage are those who have family incomes below the poverty level -- about $11,500 for an individual and $19,500 for a family of three. They are so poor they don't even qualify for subsidized policies through the federal website Healthcare.gov.

The Obama administration wants to send Florida the money, and last year Gov. Rick Scott and the State Senate wanted to take it. But House Speaker Will Weatherford and other Republican leaders balked because of their opposition to the health law.

Now, with the Legislature set to  meet in March, there’s a chorus of editorials around the state pleading and demanding that the House take the money.

"Conservative critics of the federal Affordable Care Act are long past the point where they need to put up or shut up," The Ledger in Lakeland wrote. "If they have identified problems with Obamacare or its provisions to expand Medicaid, they need to help fix those problems or provide a viable alternative."

'Put Up or Shut Up'

In a December op-ed column responding to an unflattering Times-Union column, Weatherford offered four objections to taking the money:

--"Medicaid is a flawed health care delivery system that does little to help the poor."

--"We are unconvinced that the federal government will keep its $51 billion (distributed over 10 years) promise," given the federal debt.

--"Florida already makes a significant investment in health care for low-income Floridians."

--The House passed its own plan, Florida Health Choices Plus, which did not call for any federal funds.

That plan would have covered just 115,000 people, only the disabled or those with young children at home, as Health News Florida reported in April.  The participants also would have had to pay part of the cost, an amount critics said would be unaffordable to people below the poverty level. The state's part of the cost would have come from Florida taxpayers, without tapping the federal funds.

Responding to Weatherford's column, The Ocala Star-Banner said that the Speaker's concern about the quality of Medicaid coverage "is easy to say for someone who already benefits from state-funded insurance."

Florida is already a "net donor "state, meaning it sends more tax money to Washington than it gets back, editorial writers said. State House Republicans' inaction makes that worse, Ocala said; "the state will pay the taxes that fund coverage in other states, but not get the benefits from it."

Tampa Bay Times Editorial Page Editor Tim Nickens said it's easy to see why editorial boards that usually disagree about health care reform have come together on the need to take the Medicaid money.

"There’s a demonstrated need, when you have this many people who could be helped by this Medicaid expansion," Nickens said. "Second, it’s a tremendous amount of money, $51 billion over 10 years. And that’s hard for anybody to pass up when it’s public tax money that could come back to Florida."

There's strong support in the business community, he said, including the Florida Chamber of Commerce, Associated Industries of Florida , and the health care industry -- especially hospitals. The Affordable Care Act took away some funds from hospitals anticipating they would make it up by having their uninsured patients covered.

'Obamacare has been a disaster'

The chief obstacle to taking the money is Weatherford, from Wesley Chapel in Pasco County. He has a thing about the Affordable Care Act, which he calls "Obamacare." He also rails against Medicaid as a dysfunctional government-run health system, even though  Florida's Medicaid program already relies on  private HMOs and other insurers for most patients, and the rest will be moved to private coverage in the coming year to 18 months.

Weatherford, a Tea Party favorite, pays no attention to the editorial chorus. "I don’t legislate based on what newspapers say or do or think, certainly not what editorial boards  think," he said. "We know that Obamacare has been a disaster at every phase."

Wayne Garcia, a former newspaper reporter  who now teaches at University of South Florida, also spent nine years as a political consultant. He says he’s not surprised that the Speaker is ignoring the newspaper editorials.

"The Republican Party did a very successful job of knocking newspapers off their perches, and when I say newspapers I mean that editorial voice," Garcia said. "So now I don’t know of any of the old clients I had who would be Republicans, I don’t know of any who would, you know, especially care."

He says newspapers have lost their clout to other media.

"Their influence has been diminished because  there’s a million other voices out there doing the same thing they pretty much alone used to do. Everybody else has access to money, publishing, airwaves, blogging, tweeting etc.  With the broadening of communication channels, (newspapers') message tends to get drowned out."

Health News Florida tracked editorials all year and could find just one newspaper that backed the House in rejecting the federal money, Panama City News-Herald. On Jan. 5, an editorial cited expected high costs in Medicaid and the "Obama administration's repeated backtracking on the ACA's implementation" as reasons not to take the federal funds.

But most newspapers' editorial boards are firm in their support, citing studies that found a huge ripple effect for the economy and savings in the state budget on mental health and substance abuse once the uninsured were covered.

The Times' Nickens says he’s tried talking to Weatherford about all the jobs the money would bring, how it would reduce state spending on mental health and substance abuse, and so on. The Speaker hasn't budged an inch.

In an October editorial, the Times took Gov. Scott to task for failing to get the Medicaid money for Florida, while Ohio Republican Gov. John Kasich took "extraordinary measures" to persuade his fellow party members to take the money.

"I think we’re going to need new leadership in the Legislature and a new governor," Nickens says.  The legislative session, however, ends in May, long before the elections in November.

The Tampa Tribune, which has been harshly critical of the Affordable Care Act and typically supports Republican policies, made an exception in September after city leaders from the Chamber of Commerce, USF and Tampa General issued a public plea for the state to take the money. The Tribune editorial said it respected the fiscal conservatism of Weatherford and others.

"We respect their concerns about federal spending, and we think Obamacare is deeply flawed," the editorial stated, "but their arguments are not persuasive enough to deny as many as 1 million of the state’s most vulnerable residents a chance at health insurance."

--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.