Florida business groups, insurers, and hospitals are pushing state officials to accept billions of dollars in federal funds to cover the low-income uninsured.
But when the 2015 legislative session opens next Tuesday, this impressive coalition will run into Rep. Matt Hudson, a Naples Republican who chairs the Health Care Appropriations Subcommittee.
He has opposed Medicaid expansion -- a key part of the Affordable Care Act -- ever since the Supreme Court ruled it optional for states. Now, he said, he also rejects the private-sector plan "A Healthy Florida Works," endorsed by the Chambers of Commerce and other conservative groups.
"I still believe that Medicaid Expansion is wrong for Florida," Hudson said in a recent phone interview.
Patient advocates have been hoping that Hudson and other opponents of expansion would accept it in some form if the federal government allowed Florida to impose work requirements and other rules on the newly-insured.
No such offer has been publicly made, but rumors have been circulating as negotiations between state and federal health officials continue over a different Medicaid funding issue: continuation of the Low Income Pool for hospitals and clinics that treat the poor. (See "Billions at Stake as State, Feds Negotiate Medicaid Funding.")
Asked whether work rules for beneficiaries would change his opposition to expansion, Hudson said no. "I don’t believe for one moment that this is a good plan for Florida and I would certainly not change my opinion that way," he said.
Hudson cited two reasons for his stance, starting with medical resources. The state already faces a shortage of physicians without adding hundreds of thousands more patients to the mix, he said. Eight counties have no hospital, he said, and 17 counties lack a pediatrician.
As for the federal funding for expansion, estimated at $50 billion over a decade, Hudson doesn’t believe it will last. Congress will be unable to keep the funds flowing because of strain in the federal budget, he says.
The Healthy Florida Works coalition says the federal funds' beneficial effect would stretch beyond the coverage for 800,000 to 1 million low-income adults. Based on economic studies, the coalition says the expansion would create 100,000 jobs and a ripple effect of $540 million a year.
Previous studies have noted that health coverage to the uninsured would make it possible to shrink or eliminate some state spending; for example, Medically Needy, which helps the uninsured who become poor because of severe illness, and some mental health and substance abuse programs.
Last month, after Republican-dominated Indiana reached agreement with the federal government on Medicaid expansion, WFSU reported that the Florida Senate seemed open to the expansion proposal while the House still seemed resistant. House Speaker Steve Crisafulli said at the time, "I am a never-say-never kind of guy, and certainly anything can come about that provides opportunity, but at this time we do not plan to hear Medicaid expansion."
Special correspondent Carol Gentry is part of WUSF in Tampa. Health News Florida receives support from the Corporation for Public Broadcasting.
