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Affordable Care Act

FMA Supports Medicaid Expansion Money

I recently attended the Florida Medical Association annual meeting, where the organization develops policies for the coming year. The legislative agenda is drafted and approved.

FMA delegates from the specialty groups and county medical societies will vote on each resolution coming before the House. FMA lobbyists will then bring approved policy to Florida’s legislators and congressional representatives.

I have not been a delegate for some years and I’m no longer a voting member, but all members can listen to resolutions and comment on them during the reference sessions. I have always been impressed with this process.

Obamacare has been a divisive issue for the FMA. Initially, the American Medical Association sat down to hammer out the details of expanded medical coverage for needy populations. The FMA stood firmly against the effort.

The issue was so contentious that the FMA brought a resolution before the House to end the state’s affiliation with the AMA for cooperating with the Obama administration. Conservative members in the House were hostile to Obama’s administration and the Affordable Care Act remains a target.

Fortunately, saner FMA members defeated the effort to sever ties with the AMA. Although the hostility to Obamacare continues, members are divided on the issue. When the Gov. Rick Scott administration refused the expanded Medicaid, the FMA remained silent. Most primary-care doctors and hospitals support the expansion, but conservatives refuse to cooperate with the program primarily because they oppose almost any initiative by the Obama administration.

If Florida had agreed to expand Medicaid, the federal government would have provided about $50 billion over the next decade to cover almost all the cost.

Roughly 1.3 million Floridians, mainly the needy and working poor, lost their opportunity to get health-care coverage. Estimates suggest some 4 million remain uncovered in Florida. In spite of Florida’s political opposition to Obamacare, 1 million Floridians have signed up for coverage under the program.

It was heartening to learn that the FMA House of Delegates passed a resolution to accept the Medicaid expansion money. FMA influence holds much sway with the Legislature. This endorsement represents a giant step forward to improve the health care of Florida citizens.

The FMA requirement that Medicaid pay at Medicare rates makes sense and should be implemented. Medicaid payments are historically inadequate and many physicians will not provide services at those rates.

Suggesting the equal rate structure brought to mind my argument to expand Medicare to all -- cradle to grave. I am proud of the FMA putting its usual concerns aside and making Medicaid expansion a priority.

Medicaid expansion would serve all Florida communities. It would reduce the threat of communicable disease, the number of worker sick days, and preventable death and disability. I am a career public health doctor. Medicaid expansion is music to my ears.

We cannot ignore the needs of our disadvantaged citizens. Certainly the long overdue expansion of health-care coverage would improve the lives of all Floridians.

Dr. Marc Yacht, MD is a retired physician living in Hudson, Florida.