Florida’s Failure to Accept Federal Funding to Expand Medicaid Would Create Coverage Gap

CCF’s Co-Executive Director Joan Alker was in Florida today testifying on the Florida Medicaid expansion before the Senate Select Committee on the Patient Protection and Affordable Care Act.   Joan has spent ten years researching Florida’s Medicaid program and released a report in November assessing Florida’s Medicaid choice so the committee wanted to hear from her.

I didn’t get to travel to the “Sunshine State”  but watched the live video feed and found the climate to be quite pleasant in the hearing room as the committee members seemed to be open-minded and asked good questions designed to help them make the right decision for their constituents rather than make ideological points (quite a contrast to what one sees in many Congressional hearings these days.) Click here to see a clip of the media coverage.

The stakes are very high for Florida as so many residents are uninsured.  Joan pointed out that Florida has the second highest rate of uninsured adults and the third highest rate of uninsured children in the nation.  It also has one of the lowest income guidelines in the nation for residents to qualify for Medicaid.  Parents with less than 19% of the federal poverty level or $3,711 per year for a family of three qualify for Medicaid coverage – earned income takes them up to 56% of FPL.  Non-disabled adults without children at home are not eligible at all for Medicaid coverage under Florida’s current rules.

There is a considerable amount of federal money on the table for Florida to help meet the needs of its uninsured residents.

 

“Florida is already spending taxpayer dollars for these folks when they wind up sick and in the emergency room,” said Joan Alker. “ A smarter use of health care dollars is to accept the federal funding and provide them with preventive and primary care services before they get sicker.”

 

Joan’s research has shown that the state could save $100 million annually by accepting the federal funding to extend Medicaid coverage to more uninsured Floridians.  Offering low-income adults Medicaid coverage  would help people get the preventive care they need to avoid becoming  sicker and seeking care in emergency rooms or bankrupting themselves and having to rely on the state’s medically needy program.

When questioned about what would happen if the federal government cut funding later, Joan pointed out that the matching rates were included in the statute and would take an act of Congress to change.  She also explained that other states such as Ohio and Arizona were considering triggers that would drop the expansion if the federal government reduced the matching rate.

Joan also explained to the committee that if the state chose to go forward with the Medicaid option, it had a lot of flexibility in how it would do so.  For example, benefit packages can differ from traditional Medicaid and the states can charge higher copays for non-emergency use of ERs and for non-preferred drugs.   Joan  pointed out that there is also the possibility of using the generous federal funding for premium assistance to purchase coverage through the exchange if such an approach is proven to be cost-effective.

Greg Mellow of Florida CHAIN also did a great job of explaining why expanding Medicaid would be such a great deal for Florida.  Several individuals shared their personal stories during the hearing and provided very compelling reasons for offering Medicaid coverage to more uninsured Floridians. I encourage you to check out the video.

 

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