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FL CHAIN Layoffs Tied to Trump's Election

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

Florida’s most vocal advocacy group on health issues will lay off all five of its employees next month as an indirect result of the Republican sweep in the Nov. 8 election.

Florida Community Health Action Information Network, or Florida CHAIN, had expected to receive continued grants from its major funder, Community Catalyst. The Boston non-profit has been managing a pool of foundation funds to support state-level groups that were implementing the Affordable Care Act by pushing for Medicaid expansion and helping the uninsured get enrolled in a plan.

However, the money was contingent on the law remaining in force, said Catalyst’s Deputy Director Susan Sherry.  With the victory of President-Elect Donald Trump, now the money needs to be redirected to defense of health coverage at the federal level, she said.

“It’s pretty clear that opponents of the Affordable Care Act will move forward with plans to repeal it,” she said.

Unless there is an adequate replacement for the law, she said, repeal “will strip away coverage from 22 million Americans, including 1.7 million living in Florida.”

The decision to end funding for Florida CHAIN doesn’t mean the group wasn’t doing a good job at helping people enroll in health plans and speaking up for broader coverage, Sherry said.

“We think Florida CHAIN has been doing a great job,” she said.

Among those to be laid off is Executive Director Mark Pafford, former House Democratic Leader who is leaving the Legislature because of term limits. He took the $85,000-a-year job with Florida CHAIN last year.

He said he expects to find a role that allows him to continue his work on public health and the environment.

“The politics make it really ripe to find great work,” he said. “There’s always opportunity to do good and be heard.”

Pafford said he understands why Community Catalyst put a hold on state-level funding. Given all that has happened, he said, that was the responsible thing to do.

Community Catalyst had asked CHAIN to submit a proposal for its work on Medicaid advocacy by Nov. 15. It was almost ready for submission, Pafford said, when the election stunned consumer health advocates and forced them to reset their priorities.

The most that Florida CHAIN would have received from Catalyst is $200,000, Sherry said. A larger sum was reported in an earlier article.

On the group’s website, a statement says the layoff of staff was a “prudent and difficult business decision to preserve Florida CHAIN’s ability to operate in a limited role until such time that we have a better understanding of the future of health care in Florida and the United States.”

The statement asks for individual donations and provides both a link and a mailing address. The non-profit’s directors, who are volunteers, will do all they can to keep the mission alive until renewed funding makes it possible to hire staff again, the statement says.

“We are not going away,” CHAIN’s Chairwoman Chris Fisher told the Naples Daily News

Passage of the Patient Protection and Affordable Care Act, also called "Obamacare," in 2010 made coverage for the nation’s then-47-million uninsured available in a number of ways. Large companies were required to offer coverage, and individuals who didn’t get it that way were required to obtain a plan or pay a penalty. They could buy it through an online exchange, with subsidies to cut the cost.

For those with low incomes, states could expand their Medicaid programs, using federal dollars. But the U.S. Supreme Court ruled that states did not have to accept the money, and Florida was among those that didn’t.

Florida’s uninsured peaked in 2013, at about 3.9 million, according to national data.  Enrollment efforts by the University of South Florida and others enabled 1.7 million of the 2 million who were qualified for coverage through the federal Health Insurance Marketplace to sign up, according to data compiled by the Kaiser Family Foundation. (Enrollment for 2017 in a health plan is currently under way at ) 

But Florida’s Legislature repeatedly turned down the offer of federal funds to expand Medicaid, about $50 billion over 10 years.  That money would have covered an estimated 700,000 to 1 million of the state's uninsured.

Both chambers of the Florida legislature were controlled by Republicans throughout the fight over Medicaid expansion. The Senate was willing to accept federal funds, if the Obama administration provided some flexibility in the way it was spent. But the House was not.

One of the reasons House members expressed for their opposition was their prediction that the extra federal funds would not come through, leaving the state  holding the bag. So far, states that expanded Medicaid have received the promised funds. But the election raises questions about whether that will change.   

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.