Florida just went from having the third-highest rate of medically uninsured to the second-highest. Nearly 4 million Floridians — almost 20 percent of the state — lack health coverage, according to census data released last week.
Among those without insurance are more than 500,000 children. That should bother legislators who have refused to expand Medicaid under the Affordable Care Act.
In July, federal officials asked legislators to reconsider the $50 billion they are spurning and the 1.2 million Floridians they are leaving uninsured by not expanding Medicaid. The Republican-dominated Legislature won’t budge.
The Affordable Care Act will pay 100 percent of the cost to insure the newly eligible, the working poor who make up to about $16,000 per year, in the first three years and no less than 90 percent thereafter. Florida could receive $5 billion a year in the first decade.
Michigan’s Republican legislature and governor put the needs of 470,000 uninsured citizens above ideology this week by giving final approval to Medicaid expansion. The plan will require waivers from the Obama administration because enrollees must pay up to 5 percent of their income, in cost-sharing.
“This is a bright day in Michigan,” Gov. Rick Snyder said. “It’s about helping Michiganders. Hundreds of thousands of Michiganders will have the opportunity for health care coverage.” The uninsured in Florida cannot say the same.
Gov. Rick Scott stopped opposing expansion after the Obama administration allowed the state to move Medicaid beneficiaries into managed care. But House Speaker Will Weatherford, R-Wesley Chapel, who led the charge against Medicaid expansion, and the governor won’t call a special session on the issue. Though the Senate approved a plan by Sen. Joe Negron, R-Stuart, that would have used the federal money to provide private insurance for those eligible under the new Medicaid guidelines, the House rejected it, supposedly because it involved taking federal money.
Yet those same lawmakers who claim to abhor all things from D.C. have no problem ceding control of the state’s exchange, an online marketplace where individuals and small businesses can shop for coverage. Florida is one of 18 states, most governed by Republicans, that will let the feds run their exchanges. The other states either will run their own exchange or operate them in partnership with the federal government.
States that cede control to Washington lose out on millions in grants and the opportunity to craft marketplaces that meet the specific needs of their residents. Enrollment in the exchanges begins Oct. 1. Though many of Florida’s uninsured — those earning between $16,000 and $46,000 — can get subsidies to buy coverage on the exchange, 700,000 will not. They earn less than the federal poverty level and are eligible only for Medicaid if the state expands the program
Idaho is the only state where a Republican-controlled government has opted to run its own exchange. Rep. Fred Wood, a retired emergency room physician who chairs the House Health and Welfare Committee, told Kaiser Health News that Idaho legislators recognized that there’s no use fighting the health care law. “The fact is, that gig is up, and it’s going to happen,” Rep. Wood said, “so let’s make sure we do it our way, not someone else’s way.”
Rep. Weatherford’s position hurts state hospitals and the state’s economy. Tallahassee often turns to Texas, the state with the highest rate of uninsured that has also rejected Medicaid expansion and a state-run exchange, for ideas on governing. Instead, Republican legislators should look to Michigan and Idaho.
for The Post Editorial Board