Despite rejection by Florida House and Senate committees studying implementation of the Affordable Care Act, Medicaid expansion is not yet dead. The nearly 1 million Floridians who would be eligible might still get health coverage if Sen. Joe Negron, R-Stuart, can convince lawmakers to approve a plan that uses state and federal money to buy these individuals private insurance.
It’s a big if, but it’s one worth pursuing.
Sen. Negron, who chairs a panel that voted against expansion this week, said that he wants the working poor — mostly childless adults — to be insured. He just doesn’t want them on Medicaid.
Under his proposal, they would enroll in private health plans through the state’s Healthy Kids program. Healthy Kids provides coverage to 2 million children whose families don’t qualify for Medicaid but can’t afford insurance. Like Medicaid, it is a state and federally funded program. Families pay a small premium.
Healthy Kids would do the enrollment, collect the premiums and pay insurers just as it does for existing clients. “Pretty much everything we do now we’re capable of doing under the Senate plan except that instead of us dealing with children we would be dealing with adults,” said Healthy Kids Executive Director Rich Robleto.
Sen. Negron said Healthy Kids is successful and “lives within its means.” He said it has bipartisan support and that the House is more likely to go along with a private insurance program than an expansion of a “government entitlement.”
A study found the state would save money by providing new enrollees under Medicaid expansion an alternative benefit plan versus the state’s standard plan. The federal government allows states more flexibility under expansion than traditional Medicaid.
The Republican-dominated Legislature often looks for ways to privatize government programs, and this is no exception. Lawmakers unnecessarily demonize Medicaid to make the case for private insurance.
“There are a lot of reasons not to expand our existing program,” Sen. Negron said. “It’s a precarious program. Remimbursements are bad.”
House Speaker Will Weatherford, R-Wesley Chapel, who cheered when a House committee voted against expansion, also has criticized Medicaid as “broken,” despite the fact it paid the medical bills of his deceased younger brother when his family couldn’t afford to pay.
Sen. Negron and Rep. Weatherford fail to note that lawmakers share blame for Medicaid’s shortcomings. Lawmakers set those “bad” reimbursement rates that result in fewer providers, including primary care doctors, accepting Medicaid. That leads to lower access to care and more expensive emergency room visits.
Privatization for the sake of privatization is sensless. Given lawmakers’ hostility to the health reform law, though, this may be the only way for many of Florida’s uninsured to get coverage.
Lawmakers’ dislike of anything federal, except the billions the state would get for this new program, makes us wonder if they would adequately promote it. They treated Healthy Kids like a stepchild when it began. Sen. Negron said that since the health care law requires most people to have insurance by 2014, there will be an “explosion of marketing and information.”
But marketing only becomes an issue if lawmakers do the right thing and first approve the health care expansion.
for The Post Editorial Board