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Editorial: Trump victory is a blow to group pushing Medicaid expansion


One quick and unfortunate result of Donald Trump’s victory in the presidential election: The leading voice for expanding Medicaid in Florida has taken a serious hit.

Florida CHAIN — which for 17 years has advocated for children’s health, Medicare, Medicaid and immigrants’ health care — lost its major funder, forcing it to lay off its five paid staff members and shrink to a volunteer operation, the group said last week.

A Boston-based nonprofit called Community Catalyst has been supporting Florida CHAIN with a $375,000 grant. But with Trump having campaigned on a promise to kill the Affordable Care Act — without saying what would replace it — the funder has cut future outlays until it can figure out what new health care battles lie ahead. It’s likely the money will be steered to initiatives in other states, Florida CHAIN said.

Sad to say, Medicaid expansion was a long shot in Florida, anyway. Gov. Rick Scott and the Republicans who control the state House of Representatives have adamantly refused to accept the Obamacare offer of billions of federal dollars to extend Medicaid to poor adults — men and women who have been excluded from the federal safety-net program. In Florida, for instance, Medicaid offers coverage only to low-income children, pregnant women, disabled adults and extremely low-income parents.

Since the Affordable Care Act started widening Medicaid in 2014, 31 states have opted in. And in those states, such as Arkansas and Kentucky, poor Americans are going to the doctor more and having less trouble paying for it, according to a Harvard University study published in the journal JAMA Internal Medicine. The researchers said that the program, started in 2014, is already starting to show “the kind of broad-based improvements [in patients’ health] that we would expect with greater access.”

In Florida, one out of every four working-age adults now lacks health insurance, according to census data reported by Florida CHAIN (which stands for “Community Health Action Information Network”). It’s a burden for all of us, not just the uninsured who delay going to the doctor at continued detriment to their health. When these folks eventually go to the emergency room, unable to pay, hospitals shift the cost to everyone else through higher insurance premiums or taxes.

About 567,000 Floridians now fall into a gap: too poor to afford private health insurance, but not poor enough to qualify for subsidies for buying Obamacare coverage, Florida CHAIN says. More than 70 percent of them are working poor. They toil at low-paying jobs, mostly in the service and tourism industries, where employers don’t offer group coverage.

Medicaid expansion — if Scott and the Legislature had dropped their ideological blinders and accepted it — would have been a very good financial deal for Florida. The federal government would have paid nearly all the expansion costs: 95 percent over 10 years. Our workforce would be healthier and more productive. And to accommodate the thousands more people carrying health insurance, Florida would have added hundreds more doctors and other health care professionals to the state’s economy.

Ironically, Trump campaigned on promises to help the struggling working poor. And he got a lot of their votes. Now for hundreds of thousands in Florida, their chances of obtaining health coverage — slender to begin with — are in the hands of political leaders hostile to the entire structure of federal assistance in health care.

Florida CHAIN directors, all volunteers, say they’ll do all they can to keep going until more funding becomes available to rehire staff. We hope so. The need to make sure that every working American can afford health care isn’t any less urgent because Donald Trump has been elected president.



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