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Health Expansion Moves On in Senate

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

 Defending the possible acceptance of billions of dollars in federal money, a Senate panel Tuesday unanimously approved a plan that would extend health-care coverage to about 800,000 low-income Floridians.

The plan (SB 7044), backed by the Senate Health and Human Services Appropriations Subcommittee, appears to be moving quickly in the Senate. But House Republican leaders, who for the past two years have flatly rejected accepting federal money to expand coverage through Medicaid or another program, have given no indication they will go along with the Senate.

Before Tuesday's vote, the conservative group Americans for Prosperity and the National Federation of Independent Business echoed concerns about accepting federal money as they argued against the Senate coverage plan.

"We don't believe that we should be accepting these federal funds and, two, we view this as a state's rights issue,'' said Skylar Zander of Americans for Prosperity. "We believe that a bureaucrat in Washington, D.C. can change something at the change of a wind or getting the wrong signal from a congressional member that says otherwise, and then we have to come back to the drawing board and rewrite this and go through this entire process again."

But senators pointed to the state's longstanding acceptance of federal money for health care, education and transportation and said the prospect of federal funding is not a reason to vote against the coverage expansion. Health and Human Services Appropriations Chairman Rene Garcia, R-Hialeah, said an analysis showed about a third of Florida's budget relied on federal money.

"Without the federal government, we would have a Mad Max Florida,'' said Sen. Joseph Abruzzo, D-Boynton Beach. "It would be out of control."

The Senate proposal is rooted in part of the federal Affordable Care Act that offered to pay most of the costs for states to expand Medicaid. With Republican lawmakers unwilling to approve a straight Medicaid expansion, the Senate proposal would provide coverage through private health insurers.

Nevertheless, the proposal would rely on the federal money that would go to a Medicaid expansion and also would target the same group of people. Those people do not qualify for traditional Medicaid and have income levels up to 138 percent of the federal poverty level --- about $33,000 for a family of four, according to Senate numbers.

The state Agency for Health Care Administration has estimated that the cost during the fiscal year starting July 1 would be about $2.8 billion, with the federal government paying the full tab, a Senate staff analysis said. During the following year, the cost would be about $3.7 billion, with the state required to cover $91.3 million.

Another issue coloring the debate is the possible loss of about $2 billion in another program known as the Low Income Pool, which funnels money to hospitals and other health providers to care for low-income and uninsured people. The joint state and federal program is scheduled to expire June 30, and it remains unclear whether the program will continue --- or in what form.

Senate Health Policy Chairman Aaron Bean, R-Fernandina Beach, said the state hopes to reach agreement with the federal government to continue the LIP program but needs to be prepared with another plan to help provide health care to low-income people.

"If not, we need to have options,'' Bean said. "We need to be ready. We need to be agile."

Garcia said Washington should address problems in Affordable Care Act, better known as Obamacare. But while the federal law has divided Republicans and Democrats, he said expanding coverage is no longer a partisan issue.

"To deny the hard-working men and women of this state access to health care, to me, is completely irresponsible, and we need to work on it,'' Garcia said.