It is long last time to expand Medicaid

The following editorial was published in The Daily Sun on March 3, 2022.

OUR POSITION: The 2022 legislative session is nearing an end and no one even discussed expanding Medicaid in Florida, and that is a shame.

Some of Florida’s poorest people have a health insurance problem the state refuses to fix.

The fix is easy. Florida is one of only 12 states that have declined Medicaid expansion as allowed under the Affordable Care Act. The arguments against doing so are weak and old — mostly related to the fact our lawmakers don’t trust the federal government to keep its word to pay the lion’s share of the cost. Opponents have also voiced a fear that getting Medicaid benefits will entice some people who could work, not to work.

Those arguments are just not valid.

By not accepting the federal government’s plan, which pays for 100% of the cost the first three years and 90% afterwards, Florida is leaving about 419,000 people with no health insurance. Those are people caught in the coverage gap. Their income is below the poverty level and the state says they are eligible for Medicaid. But, without expansion, those people are left out.

The fear that adding hundreds of thousands people to Medicaid would burden the state and break the bank in the future is a smokescreen. The 90% share the federal government pays is law. To change it would take an act of Congress.

And, in a 2016 Bloomberg report, a study showed states which accepted the Medicaid expansion saw no significant impact on employment levels among those who were deemed eligible for the medical benefits. And, incidentally, the federal government continues to pay the 90%.

Many states, including those like Kentucky who are heavily Republican, have embraced Medicaid expansion. It has saved hospitals millions of dollars in indigent care and given families living near the poverty line a chance for a healthier life.

Covid should have exposed the great need for better insurance coverage for people in Florida. If not that, then maybe the fact an all-time high of 2.7 million Floridians signed up for Affordable Care Act coverage this year.

Florida’s stubborn approach to Medicaid expansion is mirrored in another state that has so far declined expansion — North Carolina.

But, that state is strongly reconsidering its position.

By refusing Medicaid expansion, North Carolina has left $40 billion in federal funding on the table, according to the Urban Institute. In Florida that figure is surprisingly reported to be much lower, about $6.6 billion, but still a tidy sum. That pot of money is one reason North Carolina may put expansion to a vote in November, creating a possibility that half a million North Carolinians could get coverage.

To make the case even sweeter for North Carolina, and perhaps Florida too, is that the American Rescue Plan’s boost in Medicaid funding would possibly pay most of the cost for expansion.

And, if you need more convincing, North Carolina is looking at about 83,000 more jobs in the state in health care if it expands Medicaid.

Florida’s rejection of Medicaid expansion is surely being felt by those moving here too. People who were eligible for Medicaid in other states must find a way to pay for their health care once they establish residency here.

It is just common sense to us that is it past time for Florida to end its rejection of Medicaid expansion.

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