Florida Top Loser of Federal Medicaid Expansion Dollars
By Dr. James Palermo // August 19, 2014
ESTIMATED 1 MILLION ELIGIBLE FLORIDIANS REMAIN UNINSURED
According to a new report from the Robert Wood Johnson Foundation and the Urban Institute, Florida tops the list of states losing federal money ear-marked for Medicaid expansion as a provision of the Affordable Care Act (ACA, aka Obamacare).
FLORIDA LEGISLATURE REJECTED MEDICAID EXPANSION
In mid-February of 2013, when Florida Governor Rick Scott made the surprising announcement that he would support one of the key elements of the ACA—expansion of Medicaid healthcare coverage, which would provide access and affordability of healthcare for up to a million low-income and uninsured Floridians—hopes rose among the strong proponents of Medicaid expansion.
Those proponents, notably including Democrats, the Florida Hospital Association and the Florida Chamber of Commerce, thought that there might be a chance that the legislature would approve Medicaid expansion during the 2013 legislative session.
However, for a variety of complex and controversial reasons, and “no-confidence” in the reliability and stability of the federal economy, both the Florida House and Senate Select Committees on the ACA ultimately voted, along party lines, not to approve expansion of the Medicaid program as prescribed in the ACA.
The possibility of Medicaid expansion in Florida continues to be a focal point of attention with healthcare stakeholders, and a controversial topic in Tallahassee.
STATE TO FORFEIT OVER $66 BILLION OVER THE NEXT DECADE
Florida’s decision to opt out of Medicaid expansion will result in a loss of $66.1 billion dollars over the next decade.
The report also estimates that over a million state residents, who would be eligible for coverage under the ACA’s Medicaid expansion, will remain uninsured, and Florida hospitals stand to lose $22.6 billion in payments for treating those who might have had coverage.
Provisions in the ACA call for federal funding of 100 percent of a state’s Medicaid expansion money for the first three years, and 90 percent thereafter.
However, Florida Legislative leaders have repeatedly said they are skeptical that the federal government would be able to ensure those funds into the future.
The analysis of 24 states not participating in the ACA Medicaid expansion lists Texas, with $65.6 billion left on the table, as a close runner-up to Florida in the amount of federal funding it could have received for Medicaid expansion, and three other states, Georgia, North Carolina and Pennsylvania, as leaving more than $30 billion behind.
The Urban Institute and other proponents of Obamacare claim that the loss of ACA federal dollars for Medicaid expansion will significantly affect hospital finances and individual state economies.