Florida Medicaid expansion passes Senate, faces dead end in House


Despite facing a political brick wall in the state House, the Senate approved its privatized form of Medicaid expansion Wednesday, arguing that health coverage for uninsured Floridians is vital both to hospital financing and the state’s economy.

But short of reaching what several senators termed a “grand bargain,” the House today is poised to kill the Florida Health Insurance Exchange, which House Speaker Steve Crisafulli and Gov. Rick Scott condemn as an “expansion of Obamacare.”

The Senate approved the measure on an overwhelming vote of 33-3, but Senate President Andy Gardiner said that after today’s expected formal rejection by House members, lawmakers are ready to pivot quickly toward crafting a budget for the year beginning July 1. Work on crafting the new spending plan is expected to begin this weekend.

“At the end of the day, we have to do a budget,” said Gardiner, R-Orlando. “It’s not about personalities, it’s not about lawsuits, it’s not about threats. It’s not even our money, it’s taxpayers’ money. We’ll get our job done.”

The Senate vote came on the third day of a scheduled three-week special session. Daily costs to taxpayers will likely range between almost $24,000 to $87,000, according to historical data.

The special session became necessary after the two-month regular session ended May 1 with lawmakers angry and deadlocked over FHIX, with work scrapped on finalizing a state budget, the only bill lawmakers must approve each year.

Although Scott and the House’s opposition to FHIX only hardened in the weeks leading to the special session, senators rallied one last time Wednesday around the measure.

In speech after speech on the floor, senators touted the benefits of FHIX and what they called the failure of the House to compromise.

“We are working very hard to get to ‘yes,’” said Sen. Eleanor Sobel, D-Hollywood, who pleaded with House members to “keep an open mind.”

Sen. Don Gaetz, R-Niceville, pointed out that his own family was split – with his son, Rep. Matt Gaetz, R-Fort Walton Beach, an outspoken critic of the FHIX plan.

But the senior Gaetz insisted the Senate was right.

He accused Scott and House leaders of being inconsistent. They blistered the Obama administration for cutting federal aid to Florida hospitals, but then blasted FHIX’s reliance on drawing federal money for covering low-income, uninsured Floridians, Gaetz said.

“For those opposed to taking federal money, that train left the station long ago,” Gaetz said.

Senate Rules Chairman David Simmons, R-Altamonte Springs, called opponents “very inconsistent and illogical” in their approach to federal dollars.

The FHIX plan approved Wednesday is what Gardiner called a 2.0 version of the proposal lawmakers battled over through the regular session.

The measure originally was aimed at drawing $2.8 billion in federal funding to provide health coverage to 800,000 Floridians. Those eligible would be required to pay a modest premium and be employed, looking for a job or in school.

Tougher standards added by the Senate before the special session to blunt House criticism reduced both the amount of federal aid and the potential pool of eligible Floridians to around 500,000 people.

More provisions added this week even allowed Florida to repeal the law if federal funding levels changed.

But it clearly remains a no sale.

“The governor still opposes the bill,” said Jackie Schutz, a Scott spokeswoman, moments before the Senate vote.

Rep. Gaetz, shortly after hearing his father’s floor speech, tweeted, “I occasionally borrow Senator Gaetz’s neckties. I wish he would occasionally borrow my conservative principles.”

Although the House is expected to vote down the Senate’s health insurance expansion plan, hospital finances are certain to play a central part in the ensuing budget negotiations.

The Senate president, a hospital vice-president, spearheaded the push for FHIX, in part, to help hospitals offset a reduction of a $2.2 billion low income pool (LIP) that steers mostly federal money to health providers treating indigent patients.

LIP money is expected to be held to $1 billion this year. Hospitals say that will force them to reduce services or, in some cases, shutter completely.

Based largely on the premise that FHIX would draw Obamacare funding, the Senate budget proposals approved during the regular session was a stunning $4.2 billion greater than the House plan, but that difference would be erased by FHIX’s expected defeat.

In a first overture toward a budget deal, a House committee Tuesday reduced its proposed $690 million package of tax cuts by about $400 million to make state dollars available to help replace some of the LIP money expected to be lost by hospitals.

Senate Budget Chairman Tom Lee, R-Brandon, said Wednesday that he wasn’t sure that would be enough.

He warned that with tax cuts and increased school money remaining a priority for Scott, the House and many in the Senate, coming up with a spending plan to replace the $77 billion budget that expires June 30 may demand some reduced expectations elsewhere, including many hometown projects.

“There’s going to be a pruning,” Lee said.



Reader Comments ...


Next Up in Politics

Trump urges ban on gun devices like bump stocks
Trump urges ban on gun devices like bump stocks

President Donald Trump said Tuesday that he has signed a memo directing the Justice Department to propose regulations to “ban all devices” like the rapid-fire bump stocks involved in last year’s Las Vegas massacre. Seeking to show action days after a deadly school shooting in Parkland, Florida, Trump spoke during a White House ceremony...
Scott holds Parkland shooting meetings; House rejects assault gun ban
Scott holds Parkland shooting meetings; House rejects assault gun ban

A flurry of meetings took place in Florida’s capital on Tuesday in response to last week’s mass shooting at Marjory Stoneman Douglas High School, with dozens of leaders in education, law enforcement, and mental health pouring into the city to participate in a trio of workshops organized by Gov. Rick Scott. Some of those same leaders were...
Tom Rooney: Family the factor in leaving Congress; may run for judge
Tom Rooney: Family the factor in leaving Congress; may run for judge

U.S. Rep. Tom Rooney, R-Okeechobee, said guilt about missing time with his family was a big factor in his decision not to seek a sixth term in Congress this year. Rooney said he hasn’t decided what he wants do when his term expires in January, but he mentioned the possibility of running for elections as a judge in Florida’s 19th Judicial...
Florida Medicaid program limits opioid prescriptions
Florida Medicaid program limits opioid prescriptions

As lawmakers consider proposals to limit opioid prescriptions, Gov. Rick Scott’s administration is taking steps to do the same in the Florida Medicaid program. The Agency for Health Care Administration announced last week that, effective Monday, prescriptions for narcotics in the Medicaid program will be limited to a maximum seven-day supply...
Republican Trump critic Jetta ends challenge of U.S. Rep. Frankel
Republican Trump critic Jetta ends challenge of U.S. Rep. Frankel

Delray Beach businessman Kurt Jetta faced long odds in his 2018 campaign for Congress. He hoped to win the Republican nomination in District 21 as a critic of President Donald Trump. If he succeeded in that, he faced the tough task of unseating three-term U.S. Rep. Lois Frankel, D-West Palm Beach, in a heavily Democratic district. »RELATED: The...
More Stories