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Obamacare or Bust: U.S. Tells Florida to Either Expand Medicaid or Lose Out on Billions

| December 11, 2012

It’s a matter of access and quality.

Florida and other states will have to fully expand Medicaid eligibility if they want to tap into billions of dollars in extra money under the federal Affordable Care Act, Obama administration officials said Monday.

The announcement cleared up a lingering question for states deciding whether to dramatically increase the number of people enrolled in Medicaid when the federal law, better known as Obamacare, takes full effect in January 2014.

The Affordable Care Act says the federal government would pay 100 percent of the cost of the expanded eligibility from 2014 through 2016. But states questioned whether the federal government also would cover the full costs for a partial Medicaid expansion — an idea that the Obama administration officials rejected Monday in a conference call with reporters and in documents posted online.

“The law does not provide for a phased-in or partial expansion,” the federal Centers for Medicare & Medicaid Services said in a document. “As such, we will not consider partial expansions for populations eligible for the 100 percent matching rate in 2014 through 2016.”

Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, also sent a letter to governors Monday emphasizing that the federal government would pay the full cost of the expansion in its initial years. After 2016, the federal share would gradually drop to 90 percent in 2020.

“We continue to encourage all states to fully expand their Medicaid programs and take advantage of the generous federal matching funds to cover more of their residents,” Sebelius wrote.

Florida Republican leaders have been skeptical of the Medicaid expansion, at least in part because of potential long-term costs. Legislative leaders and Gov. Rick Scott frequently complain that the roughly $21 billion Medicaid program absorbs too much of the state’s budget.

“Medicaid has grown faster than any other part of our budget,” Senate Appropriations Chairman Joe Negron, a Stuart Republican who also chairs a select committee on the federal health law, said last week. “It’s crowded out our ability to fund higher education, transportation and other equally valid and worthy parts of our budget. So as we make these tough decisions, we have to take that context into account.”

Monday’s announcement centers on a portion of the Affordable Care Act particularly aimed at expanding Medicaid eligibility for childless adults, who often do not qualify for the health-care program. The law would expand eligibility to people whose incomes are up to 133 percent of the federal poverty level, though officials say the eligibility limit actually would go up to 138 percent of the federal poverty level because of what is known as a 5 percent income “disregard.”

Currently, a one person household could have income up to $14,856 and be at 133 percent of the federal poverty level, while a two-person household could have income up to $20,123, according to the website of the advocacy group Families USA.

The federal government already pays more than half the costs of Florida’s Medicaid program. But paying the full cost of the expanded eligibility is designed as an incentive for Florida and other states to extend coverage to more people.

In Florida alone, the federal government would be expected to spend $863 million during the 2013-14 fiscal year on expanded Medicaid eligibility — a total that would grow to about $3.1 billion during the 2015-16 fiscal year. The state’s costs are estimated to start at $79 million during the 2016-17 fiscal year and rise to about $330 million in 2020-21, according to August projections by state analysts.

Monday’s Medicaid announcement also came as a deadline looms Friday for states to notify the federal government about how they plan to handle health-insurance exchanges under the federal law. The exchanges, which will start operating in January 2014, will be online health-insurance marketplaces designed to help people shop for insurance coverage.

If states don’t establish exchanges, the federal government will do it for them. Another option is for states and the federal government to form partnerships to operate exchanges.

During Monday’s conference call, federal officials announced that six states have received conditional approval for their exchanges. Those states are Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington.

Federal officials initially sought answers from states in November about exchange plans, though a deadline was pushed back to Dec. 14. In the documents released Monday, federal officials said they would not extend the deadline again.

Florida House and Senate leaders have already made clear the state will not run a health-insurance exchange in 2014, as a decision could not be made until the 2013 legislative session. That position was reiterated Monday in a new Senate webpage about the federal health law.

“Florida, and several other states, did not submit a letter to the Secretary of Health and Human Services by the November deadline to indicate an intention to operate a state based exchange for health care coverage in calendar year 2014,” the new Senate webpage says. “Another deadline is set for December 14, but Florida’s position is unlikely to change at that time.”

–Jim Saunders, News Service of Florida

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17 Responses for “Obamacare or Bust: U.S. Tells Florida to Either Expand Medicaid or Lose Out on Billions”

  1. Magnolia says:

    Fortunately for the state, we still have a Congress.

  2. confidential says:

    Right on!!
    What services we are forced to provide and pay to all Florida legislators in Tallahassee and DC, as well to this Governor, we should all have the right to receive as well. Otherwise what kind of totalitarian regime is the one we have in Florida? Enough is that we live in a Right to Work (for Less) State.

  3. glad fly says:

    freebies for all or socialism…same thing.

  4. Anon says:

    Gov Scott and his cohorts were hoping for a different result of the presidential election.

    Then they would have had the backing of the administration to manhandle the poor.

  5. Samuel Smith says:

    If you don’t like socialism, renounce your social security benefits and medicare when you hit retirement age.

    • Magnolia says:

      @Samuel Smith,

      Why? This is our money which has been taxed umpteen times before giving it back to us. This is money we EARNED.

      • Samuel Smith says:

        You don’t understand how social security works. Social security is an entitlement. You aren’t getting your money back, you are getting an entitlement due in part to taxes that you paid. Medicare is an entitlement.

        Again, if you’re dead set against socialism refuse your entitlements.

        • Magnolia says:

          @Samuel Smith,

          I do understand how social security works. The government steals my hard earned money without my permission, spends my money and more, and then tries to call it “security”. That’s what socialists do, tell you it’s for your own good. Then, instead of spending less, they spend more, telling you it’s for your own good. And the cycle continues unabated until we are all slaves of government.

          We’re not so secure at the moment, are we?

          Obama talks about taxing the rich at 45% when he’s already getting half my paycheck. Under his definition, everybody is rich.

          When does it end?

    • SocialSam says:

      Ok, we will just take yours. Because in a socialistic society what is yours is MINE !!!!

  6. Deep North says:

    I find it funny how people say we are becoming a socialist nation. You poor pathetic fool…we were already a socialists nation under FDR’s program of the New Deal. Yet I find it really funny how people say the government is infringing under their medicare (?). It’s like the old saying, “Tell your government to take their hands of my medicare!” I’m sorry, medicare is a government program. And if you want to privatize it, good luck. Because chances are, private health insurance can deny or cancel your care at anytime they want. I also find it funny how Republicans wanted to removed the US Department of Education. Why would you do that? We need a standardized education and a competitive one! People say we don’t need regulation. Good luck with the Reagan administration minded folks giving block grants to state education system to help out their education, only to use millions of dollars to construct a football stadium instead of investing it in the students or academic materials.

  7. Yellowstone says:

    Someone in the Florida legislature has got to get a grip . . .

    Ok, so you don’t want the ACA – good for you! Just like the GOP to say during the recent campaign – “Go to the emergency room to get help”

    So, smart alecks, who do you suppose is going to pay for all those who have no healthcare, and are now waiting in line at Florida Hospital Flagler?

    Watch your next tax statement . . . (That’s who!)

  8. Jojo says:

    Socialism! This Gov Scott is a dictator! Give us our Medicare money back you thief.

  9. Nancy N. says:

    Gov Scott is just against all this expansion of government healthcare programs because he’s mad he can’t steal from them anymore. “If I can’t have my hand in the cookie jar, no one gets any cookies….”

  10. Sarah Martins says:

    Every action Nobama takes is one step closer to the US becoming a socialist country. All the fools who voted for him fall into only one of two categories:

    1. Slackers/moochers
    2. Guilty wealthy people

    This country is going to hell in a [solar] hand basket.

    I wonder how the people in these 2 categories will feel when there are no more producers in this country and the government has taxed the rich into poverty. Bunch of morons.

  11. Sweet Republican Tears says:

    My advice is to leave this country and its impending socialist conversion and move to somewhere distinctly capitalist, like Liberia.

  12. Sea dog says:

    Gov. Rick Scott stole billions from Medicare and took the 5th 75 times when questioned about the thefts. I am quite sure the gravy train is way to big for him and his republican friends to not get aboard.

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