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Officials Shrug Off Medicaid Jobs Report

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

If President Obama was hoping the lure of 63,800 jobs would sway Florida's Republican officials to expand Medicaid, he was mistaken.

Neither the governor nor legislative leaders had anything positive to say about the estimate by the Council of Economic Advisors released by the White House on Wednesday. The report offered a state-by-state forecast of the number of jobs that could be expected from expansion of health insurance to the low-income uninsured.

Gov. Rick Scott's re-election opponent, former Gov. Charlie Crist, said the report showed that Scott was costing the state jobs. Scott's campaign spokeswoman responded by bashing Crist's record and boasting of job growth under Scott. But the campaign did not address the subject of the report, according to The Tampa Bay Times.

Florida has not accepted the offer of federal funds -- estimated at $51 billion over a decade -- provided in the Affordable Care Act to cover uninsured people who fall into a gap. Florida has about 850,000 of them. They don't qualify for state Medicaid, but fall below the federal poverty level and thus can't qualify for subsidized coverage through the federal exchange, the Health Insurance Marketplace.

States that agreed to expand Medicaid -- or a substitute private program that offers similar coverage -- received 100 percent federal coverage of the costs for three years, beginning this year.  Florida has missed the first year, but there are still two years to go. After that, the state has to kick in a percentage, leveling off at 10 percent after 2020.

According to the Times, which tried to get a response from top state officials, none of them had a changed his mind about taking the money.

One who had no regrets was outgoing House Speaker Will Weatherford, who in 2013 engineered the defeat of a Senate-passed bill that would have sought to use the federal money for private-plan coverage. He told the Times that he was "skeptical" of the job creation numbers and still has doubts the federal budget can sustain Medicaid expansion funding.

Incoming Senate President Andy Gardiner, R-Orlando, said he sees little chance of the House changing its mind. The incoming Speaker, Steve Crisafulli, made his continued opposition clear in a recent interview with News Service of Florida.

In that interview, Crisafulli said he would not agree to expand Medicaid. When asked about trying for a private insurance program that could use the federal funds, he said, "No.  I don't believe depending on the federal government to fund the program is appropriate for us. Everything about Obamacare has been a disaster, and expanding Medicaid as the federal law allows would be no different."

Crisafulli, R-Merritt Island, said he could go along with a plan like the one offered by allies of Weatherford. That plan, called Florida Health Choices, would have relied only on state tax dollars, $237 million, and would have covered only disabled adults and parents with minor children still at home.

Critics cited three problems with Florida Health Choices Plus: It would have covered just 115,000 at most, leaving most of those who lacked health insurance no better off; most who actually qualified for the coverage would not have been able to afford the premiums and co-pays; and by turning down federal tax dollars, state residents would be taxed twice to cover the same population.

After the vote in 2013, Health News Florida provideda summary of opponents' objections

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.