Florida Senate pushes alternative to Medicaid expansion

TALLAHASSEE, Fla. (AP) – A push to offer health insurance to nearly 1 million low-income Floridians started anew on Tuesday as state senators took their first votes in favor of a measure that would draw down billions in federal aid.

A Senate panel unanimously approved legislation that would expand coverage to Floridians who do not currently qualify for existing safety net programs.

But just like past efforts, this one appears destined to split the Republicans who control the Florida Legislature. GOP leaders in the House and Senate remain at odds over whether to move ahead with a bill that ultimately relies on money linked to President Barack Obama’s health care overhaul.

“This is going to be a very hard bill to pass, extremely hard, the odds are against us,” said Sen. Don Gaetz, a Niceville Republican and former senate president.

Gaetz and other Senate Republicans contend they have to act during the 60-day session because of the potential loss of more than $1 billion in federal aid that is now flowing to hospitals to help pay for the poor and uninsured.

Florida receives the extra money for hospitals as part of a deal first negotiated when former Gov. Jeb Bush was in office. Now federal authorities say they have no plans to keep the arrangement intact in its current form.

Without something else in place, Senate Majority Leader Bill Galvano warned that the state’s hospitals could be confronted with deep cuts and some may have to close. Senate President Andy Gardiner, meanwhile, has said he will not move ahead with a budget for this year without confronting the potential loss of the money.

“The passage of this bill is a responsible, realistic act,” said Galvano, a Bradenton Republican.

House Republicans, however, remain unconvinced. They have said they don’t want to expand an already broken system and also worry the federal government won’t follow through on its payment promise.

Rep. Matt Hudson, a Naples Republican, contended that federal authorities were engaged in “politics” in an effort to get Florida to join the ranks of other states that have taken federal money tied to the president’s health care law. He noted other states have been able to keep their supplemental money for hospitals without expanding Medicaid.

House Speaker Steve Crisafulli said the House would not be drawing up a companion measure.

Gaetz, however, called it “intellectual dishonesty” to say it is acceptable to take one form of federal aid for health care but not another kind.

The bill approved by the Senate Health Policy Committee would set up the “Florida Health Insurance Affordability Exchange Program” and would offer coverage to adults aged 19 to 64 and who earn up to 138 percent of the federal poverty level, or about $33,000 for a family of four. The legislation (SPB 7044) would eventually require enrollees to pay premiums. It also includes a requirement that participants work or go to school.

The Senate bill could also provide a potential solution if the U.S. Supreme Court rules against the subsidies given under Obama’s health care law because the exchange set up under the bill could be expanded to eventually include the 1.6 million Floridians who are currently insured through healthcare.gov.