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With 800,000 Floridians in Health Insurance Limbo, Hopes Return for Medicaid Expansion

| December 15, 2014

Missing patients: nearly 1 million Floridians lack health insurance because they fall in the so-called Medicaid gap that keeps them from getting benefits under Obamacare, but only because state government refused to expand Medicaid benefits in the past two years. (© FlaglerLive)

Missing patients: nearly 1 million Floridians lack health insurance because they fall in the so-called Medicaid gap that keeps them from getting benefits under Obamacare, but only because state government refused to expand Medicaid benefits in the past two years. (© FlaglerLive)

A coalition of businesses groups, local officials and healthcare industry representatives has rolled out a plan to insure nearly one million low-income Floridians. But they’re not calling it a Medicaid Expansion.

More than 800,ooo Floridians are in health insurance limbo. They fall into what’s called the Medicaid coverage gap. Reed Mahoney of Tallahassee, is among them.

“I was told I didn’t qualify for any subsidies because I was Medicaid eligible under the federal guidelines, but not the state guidelines,” Mahoney said of his attempt to get insurance through the federal government’s website earlier this year.

Mahoney tried to get health insurance through the Affordable Care Act but couldn’t because his income is too low. He doesn’t qualify for Medicaid from the state, because his income is too high.

“The least expensive plan for me with a 5,000 deductable was $499/month. Now, if I made about $400 more, that same plan would have been $60,” Mahoney said.

For the past two years a plan to insure nearly a million people like Mahoney has failed in the Florida legislature. But a coalition of groups is pushing for change again. This time, they’re not calling it a Medicaid Expansion, because that’s a dirty word in the Florida legislature. Instead, the proposal is called, “A Healthy Florida Works”. And it goes like this:

An outside vendor would be hired to run an exchange-like system.  Florida would pull down 50-billion dollars in federal dollars to fund insurance and pay for the program. Unlike traditional Medicaid, there are premiums, which would be based on income. People would be required to work, or look for work, and education could be substituted for that.  The issue of the cost-sharing and work rules are important because it could make the plan more appealing to Florida’s Republican legislative leaders, who have pushed for such requirements in the state’s current Medicaid program.

“We think shared responsibility is an important piece of this, and when people are engaged in their own health, it leads to healthier behaviors, and that’s important.”

It’s not just individuals: businesses, too, are hurt by the coverage gap.

Jennifer Fennell is the spokeswoman for “A Healthy Florida Works”. This year’s effort to cover people in the Medicaid Coverage gap is also well-timed. The mandate that large employers—defined as those with 100 or more employees—provide insurance plans to their workers is going into effect. In 2016 the mandate kicks in for firms with more than 50 workers. Fennell says companies are doing the math.

“You’re going to have a lot of Florida businesses that are facing financial penalties of $2,000-$3,000 per employee if they can’t provide those employees health insurance. Not just those employees, but their dependents. So we really need to do something to help those businesses now,” she says.

Hospitals and other providers are also feeling the pinch, because they still have to pay to treat patients who are uninsured. The federal government has provided funding for hospitals that treat large numbers of uninsured patients—but that funding is steadily decreasing.

And then, there’s the politics. Which means getting it through the Florida legislature and to Governor Rick Scott. The Governor has said he supports expanding Medicaid, but has done little to actually push it, and when asked about “A Healthy Florida Works” Scott says he, “hasn’t seen it yet.”

Meanwhile the biggest obstacle is getting the plan through the Florida House, which has been adamant in its opposition to mostly everything related to the Affordable Care Act. Its new leaders say they’re willing to take a look at the proposal.  But some healthcare advocates are worried about parts of the plan– like the idea that the state’s Medically Needy Program could go away. Medically needy is a cost-share system for people who, aside from income—would otherwise be eligible for Medicaid. Under the Healthy Florida Works plan, that program would disappear, and its funding would be used to cover Florida’s share of the cost for the Medicaid Expansion population. Supporters say those people would still be covered, but it worries  Leah Barber Heinz, who heads the healthcare advocacy group, Florida Chain.

“That’s a really good example of what I was saying—we really don’t have enough information,” she says. “We definitely would have to learn more about what that means for the medically needy program because there would still be a need for that program in our state, as far as we can tell.”

Others, like Damien Filer, with the group Progress Florida, say getting something in place, even if it’s not ideal—is far better than the status quo.

“I just don’t see any way we can let another year go by and let these people continue to wait. And for some of them, they won’t even–they won’t have that luxury.”

If the plan does get through the legislature it will have to pass the smell test with the federal government. The same work requirements and premium payments that could give it a win in the Florida legislature, could also prove problematic with the federal government, which has refused Florida’s work requirements and premium payments for low-income people in the past.

8 Responses for “With 800,000 Floridians in Health Insurance Limbo, Hopes Return for Medicaid Expansion”

  1. attila says:

    I’ll bet all 800,000 voted for Obama and Obamacare.

  2. sw says:

    I refuse to get involved until I know what is going to happen period F-it all.

  3. says:

    If our fellow men, women and children in financial distress do not have Health Insurance = Medicaid is because the GOP majority tyrannical courtesy of our Florida House. Real show of Feudalism!

  4. Rick Gardner says:

    What kind of person or people would deny health insurance to poor people??? Oh yeah the Rs would

  5. NortonSmitty says:

    So Governor Rick and the Republicans (Great name for a rock band ny the way) keep telling us we can’t afford to add this entitlement program expansion to our National debt? We want y’all to be healthy, but we just can’t afford it.
    Meanwhile, we have occupying troops worldwide, combat units fighting in a dozen useless hot and cold wars, we’re funding ISIS and AlQueda with a black budget of untold proportions, Billion dollar fighter planes that cannot fight, a National Security Police State with a budget that gives Hermann Görings’ corpse a hard on, billions supporting coups in Ukraine and Syria and of course our annual $15 Bi;;ion tithe of welfare to that plucky little Israel.
    And looking at that, what true blue American Conservative would possibly deny the reason for our horrific National Debt? It’s all because we just don’t have the common sense to kill Obamacare, cut Grandmas’ Cat food budget and shred those extravagant teachers pensions of course.
    I can’t wait until ’16 when you can take the Congress Addleson bought you and hand it over to Bush the Smarter. You Patriots will really straighten things out then! I can hardly wait.

  6. Lancer says:

    Oh yes, the “horrible, greedy, filthy Republicans…blah, blah, blah”. What complete drivel! After the comments of Gruber, it’s alarming that people can still defend ACA/ Obama-care.

    The ENTIRE bill was based on lies, misconceptions and fraud. It was admitted by a man who received millions in tax dollars and was briefing Obama in the WH. In fact, Gruber called people who voted for Democrats…”STUPID”. Yes, an MIT liberal democrat, who helped promote a bill based on pure fraud that was passed completely by democrats (not a single republican vote), thinks that if you voted for the people who passed this bill…you are stupid.

    Meanwhile, Obama got Time’s Lie of the Year with his…”if you like your doctor, you can keep them” which barely beat out his other lie,”if you like your insurance, you can keep it”. All the while, Obama, Gruber and their ilk knew that premiums would rise, millions would lose their insurance and preferred doctors.

    Don’t forget…Obamacare/ ACA also gutted medicare.

    If, at this point, you still try to defend government healthcare, in any way, you are exactly what Gruber thinks you are…

  7. attila says:

    A lot of people rag on the GOP when they’re playing the blame game. The GOP is trying to clean up the MESS the liberals made. If you’re going to blame someone look in the mirror..

    • annomymous says:

      Attila , Republicans start the Greed wars destroy the economy, and Democratic Presidents gotta come in and clean up their mess , been happening for yrs.

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