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Despite $51 Billion For the Taking, Florida Unlikely to Expand Health Coverage in 2014

| November 25, 2013

Florida's message: keep waiting. (Daniel john buchanan)

Florida’s message: keep waiting. (Daniel john buchanan)

Consumer groups, hospitals and insurers are clamoring for Florida to take the $51 billion in federal funds that have been offered to the state over the next decade to provide health coverage to the working poor. But those who are tuned in politically —  even those who desperately want it to happen — say it’s very unlikely in 2014.

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“I think the right decision financially and morally is for Florida to take the money,”  Alan Levine, a Naples hospital executive and Republican insider, told reporters Thursday.  “But I would say (the chances) are very low, less than 30 percent.”

He said there are multiple reasons, including political rancor and misunderstanding of Medicaid financing. Also, 2014 is an election year.

Most other speakers at the three-day workshop in Miami were similarly dubious.

“I don’t think they’re going to do it in this session,” said Linda Quick, president of the South Florida Hospital and Health Care Association. She spoke to the journalists attending the seminar on Wednesday night.

Timing is part of the problem, she said, given the disastrous launch of the enrollment site, Healthcare.gov.

“We had almost convinced (House Speaker Will Weatherford) he looked stupid, turning down $51 billion, and then came the Obamacare website,” Quick said. “Now they can say (the federal government) is incompetent.”

“I think it may be five years” before Florida lawmakers relent and cover adults whose income is under the poverty level,  said Drew Altman, president of the Kaiser Family Foundation. “Florida may be one of the last states” to act.

Several lobbyists and others who work for hospitals and insurance companies, unwilling to be quoted,  just shook their heads when a reporter asked them away from the microphones if the matter had a chance in the 2014 session.

The Kaiser Family Foundation — which has no relation to Kaiser Permanente Health Plan, but is the parent organization for Washington-based Kaiser Health News  — served as host to more than a dozen journalists from national and in-state publications for the seminar Monday night through Thursday. The foundation invited prominent speakers from the private sector to brief the journalists on the rollout of the Affordable Care Act in Florida.

The group included Sarah Boseley, health editor for The Guardian newspaper from London, who created a major flap in Florida by writing an article posted Thursdaywith the headline: “Florida in secret talks to accept funding for Medicaid from Affordable Care Act.”

Boseley pegged her story on comments from two of the speakers: Donna Shalala, president of University of Miami, and Patrick Geraghty, president and CEO of Florida Blue (formerly known as Blue Cross Blue Shield of Florida).

To be sure, during their talks both Shalala and Geraghty sounded upbeat about the likelihood that Florida’s Legislature will pass some substitute for Medicaid that would enable the state to accept the funding. The Senate did just that in this year’s session, but House Republicans led by Weatherford voted it down.

Shalala, who served as Health and Human Services Secretary under President Bill Clinton, said she thinks Florida Republican leaders will find a way to get past the politics and take the money.

“When people say to me, is Florida ever going to come around, my answer is yes, because a billion dollars is on the table and the stakeholders are big contributors to the Republicans – to the party,” she said. Stakeholders include those who stand to benefit: hospitals, insurers and to some extent big business.

“They understand that it will be a major economic investment in the state and they are just trying to figure out a way around the ideology in the conversations that are going on,” Shalala said.

Later at a Florida Blue retail center in Kendall, Geraghty said he shared Donna’s optimism. “It doesn’t have to be Medicaid, but we should take the funds. We don’t think that money should be left on the sidelines. It’s a more rational way to move money through our health care system, and nearly 1 million people should benefit.”

But neither Shalala nor Geraghty said exactly when they thought the House would act. Most of the other speakers said they expect a delay of at least a year, maybe longer.

Shortly after The Guardian posted the article, several state officials issued statements saying it was mistaken. Rep. Richard Corcoran, R-Land O’Lakes, called the Guardian story “incorrect on multiple levels.

Corcoran, chairman of the House Health and Human Services Committee, said it appears that the reporter confused talks relating to the Low Income Pool payments with Medicaid expansion, which is part of what he called Obamacare. The pool payments are federal funds for hospitals that treat a great many uninsured patients.

Corcoran concluded by saying the House “would welcome any talks providing Florida the flexibility to spend tax dollars more wisely and has no interest in expanding Obamacare under its current inflexible and irresponsible terms.”

During his presentation, Levine said he thinks it’s possible for Florida’s House leaders to accept an alternative to Medicaid that would give the state to design its own program, using all the federal funds (besides Medicare or military spending) that are now a patchwork of programs — from KidCare to Medically Needy to food stamps.


But such a radical transfer of power would require the federal government to waive a host of rules, and even when waivers aren’t controversial, the process of applying, negotiating and approval takes months — usually a year or more.

Levine said the billions in federal funding that are being offered to Florida would cover nearly 1 million low-income adults who will not be eligible for the Health Insurance Marketplace because their incomes are below the federal poverty level — about $11,500 for an individual.

Covering those adults would provide income to hospitals that they are losing through other parts of the Affordable Care Act, Levine said. So by turning down the money, Florida officials are dooming hospitals to financial hardship, which could hurt both staff and patients.

Hospitals in the chain where he works, HMA, have already laid off 700 staff members, he said, and other hospitals are being forced to do the same.

Levine served as Secretary of Florida’s Agency for Healthcare Administration under former Gov. Jeb Bush and as Secretary of Health and Hospitals for Louisiana Gov. Bobby Jindal before moving back to the private sector. He is leaving HMA to become president and CEO of Mountain States Health Alliance in Johnson City, Tenn., in early January.

–Carol Gentry, Health News Florida

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18 Responses for “Despite $51 Billion For the Taking, Florida Unlikely to Expand Health Coverage in 2014”

  1. Diana L says:

    What a shame. This ends up costing us so much more money just for Scott’s political ideology. I can’t wait to get rid of him. He is a disgrace.

  2. Florida Native. says:

    When did it become so trendy to give sorry-ass people free anything? Get off your lazy asses and get a job. If you can’t get a job go door to door and ask to mow somebody’s lawn or clean their gutters or walk their dog. We are rapidly turning int a socialist society. I’m not talking about disabled people or the elderly. I’m talking about the beer,cigarette and lottery ticket crowd that sleeps until noon everyday and always have their hand out. The state or federal government doesn’t owe you s–t.

    • The Truth says:

      Why is it that if someone needs assistance they are quickly labeled as “lazy, sorry-ass people”? It’s as if you right wing, conservative nut jobs have never had a trying time in your life. Are there people that leech the system? Sure there are. For the most part, those on assistance are trying to “get their sorry ass a job” but it isn’t as easy as you think (and never will be). It’s also not as easy as you think to find a corporation willing to provide health insurance. Companies have been doing whatever possible to avoid providing health insurance for many years (yes, even before the big, bad, evil Obamacare was enacted). Of course, “corporations are people, my friend”… right?

    • Anonymous says:

      @Florida Native says–Would you prefer that those “lazy ass” poor of whom you speak (which would include children but I guess they should should get off their sorry asses and work too) to become so desperately sick that they have to crawl on their hands and knees to the ER and beg for help? I am sure that you will be SO happy to make up for the cost of services that they have no prayer of being able to pay for. Not only is that not compassionate, it’s not even smart.

    • Paul Bannerman says:

      I hope that you have good insurance.
      You need to see a good cardiologist to swap out that hatred-filled malignancy they call your heart.

      Happy Thanksgiving!

  3. The Truth says:

    Further proof that our politicians are all about the politics and not about helping people.

  4. Genie says:

    Why is there no mention of state Medicaid insurance in this article? It has always been available to low income families, long before Obamacare.

    • Anonymous says:

      Genie–Governor Scott has turned down an expansion of Medicaid funds. Where have you been?

      • Genie says:

        @ Anonymous: I was referring to the fact that insurance coverage has ALWAYS BEEN AVAILABLE. It has been THE LAW.

        Under Obamacare, the feds would pick up the tab for the first 3 years, and then the TAXPAYERS OF FLORIDA would pay.

        THAT is why he ruled out a massive expansion. We just don’t have enough rich people here in this state to pay for all this.

        • A.S.F. says:

          But you WILL pay for it, Genie. All consumers end up paying the unpaid bills of the uninsured. Do you think that hospitals, doctors and pharmaceutical companies just eat those costs out of thin air and the kindness of their hearts?

    • palm coaster says:

      correct. Only if you have kids or are over a certain age. But a 50 year old with no insurance cannot get medicaid

  5. Donna Heiss says:

    Am I reading this article correctly? I believe it is about the WORKING poor. This growing group of people are not lazy, have a job and are unable to make ends meet. In all honesty, if they stopped working at a low end paying job, (think target, Wal-Mart, etc) they would actually be eligible for government assistance at the tune of $35,000 to $38,000 a year when you tally all the benefits.

  6. confidential says:

    Also our Veterans are ignored due to lack of Medical help and is a shame: http://www.cnn.com/video/data/2.0/video/us/2013/11/20/ac-dnt-griffin-veterans-dying-waiting-for-care.cnn.html

  7. Donna Heiss says:

    @Palm Coaster. True, but there are ways to claim disability. And the 50 “somethings” are dong it.

  8. Joe E says:

    @ Donna Heiss. So if I collect government benefits I will collect about $35,000. And that is what is wrong with America. We give people $$$ and they don’t have to doing anything for it.

  9. A.S.F. says:

    Yes, let’s all just assume that people are lazy rather than ill or desperately down on their luck or simply temporarily in bad straits and needing some extra support for themselves and their families. Such an upright moral mindset makes us seem like such a exemplary nation, based on Judeo-Christian ideals and values. All you Neo-Conservatives out there, I am sure that Jesus would be SO proud you, especially when you spew this prejudicial and entitled bull**it in his name.

  10. I/M/O says:

    While the Affordable Health Care Act may grant people access to Health Care Insurance absolutely no one in this nation has yet been made aware where these people will access Doctors and Hospitals to utilize said health insurance.

    HealthCare.gov does not identify which Doctors are in a network, which doctors will be left in a network and therefore which hospitals will accept these patients cannot be determined. A Doctor cannot simply go into a hospital and treat their patient. They have to have hospital privileges to do that.

    So until that is determined Florida should not accept the 51 billion dollars.

    • A.S.F. says:

      @I/M/O says–And if we had followed that same philosophy when Medicare started, you’d still be waiting for it to kick in.

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