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Article
Courtesy of The Miami Herald
By Mary
Ellen Klas
Published
June 8, 2015
The Florida House rejected a Senate bill to expand
health insurance coverage to thousands of Floridians on Friday, putting
a temporary end to a bitter and divisive legislative fight that saw no
winners.
Aided by the threatened veto of Gov. Rick Scott, the GOP-majority House
voted 72-41 to kill a long-shot attempt by Senate Republicans to find a
way to draw down federal Medicaid money to augment health insurance for
as many as 600,000 low-income working Floridians.
After nearly seven hours of debate in special session, House Republicans
rejected the plan that required federal approval for a never-before
sought waiver under a privately-run health insurance plan called the
Florida Health Insurance Exchange, or FHIX.
The uncertainty of the waiver’s success and the philosophical opposition
to accepting federal dollars for a safety net program for the working
poor were antithetical to the conservative ideals of the lawmakers that
run the House.
“This is not the best policy for Florida,’’ said Rep. John Wood,
R-Winter Haven, who urged lawmakers to reject the bill “not to oppose a
president or party, but to oppose an ideology that has failed for
decades.”
“Medicaid is socialized health care insurance,’’ said Rep. Jason Brodeur,
R-Sanford, saying the Senate plan creates “permanent dependency” on
handouts for “able-bodied childless adults” and props up a broken health
care system.
Four Republicans in vulnerable districts, most with large numbers of
uninsured, sided with Democrats to support the plan — Reps. Shawn
Harrison of Tampa, Rene Plasencia of Orlando, Ray Pilon of Sarasota and
Holly Raschein of Key West. None spoke during the lengthy debate.
The House’s failure to take up the Senate’s call for a long-term
solution to the state’s uninsured during the regular session led to a
stalemate and the need to reconvene a special session this week.
The defeat in the House came despite an intense push in favor of the
Senate’s plan by consumer groups, business leaders and a television ad
campaign run by a consortium of hospitals and health care organizations.
It also came with no alternative plan in place, prompting lawmakers to
acknowledge they will be back within months dealing with the burdens of
the uninsured in next year’s budget. Lawmakers return in January for the
2016 session.
“Let’s come together and let’s focus on care reforms that actually make
access synonymous with coverage,’’ said Rep. James W. Grant, R-Tampa,
adding he is “prepared to lose my job” over his vote opposing the bill.
The week began with a last-ditch effort by senators to try to appease
opponents in the House by moving away from traditional Medicaid
expansion, while shifting incentives for the uninsured from expensive
emergency room care to lower-cost prevention through primary care.
Under the FHIX plan, low-income Floridians could have purchased
subsidized private insurance from either a new state exchange or the
federal exchange under the Affordable Care Act. It would have been paid
for with Medicaid expansion money.
Several opponents continued pointing out flaws in the bill, but no one
accepted the Senate’s invitation to draft amendments to fix them.
Rep. Carey Pigman, R-Sebring, an emergency room doctor, said the bill
will do nothing to discourage people from using the emergency room as
primary care.
“It’s costly for patients. It’s costly for providers,’’ he said. “It
simply expands Medicaid coverage with state and fed money thereby
allowing additional borrowed money to flow into a delivery system.
Coverage does not necessarily equal access and access does not
necessarily equal health improvement.”
Others warned that the federal government will never approve the
requirement that anyone who obtains the insurance show they are working,
getting job training or have an exception to those requirements.
“What’s positive about this bill will never be approved, but the
taxpayers of this state will have a hook in their mouth for years to
come,’’ said Rep. Paul Renner, R-Palm Coast.
House Democratic Leader Mark Pafford, of West Palm Beach, said much of
the warnings “were battling a demon that doesn’t exist.”
“If FHIX is not the answer, then what is,’’ he asked. “We’ll be back and
we’ll be talking about the same issue because it’s going to haunt the
state of Florida.”
Democrats told personal stories of being uninsured or tales of
constituents struggling to get coverage.
Rep. Shevrin Jones, a West Park Democrat, spoke of being hospitalized
with a rare blood condition and having no insurance.
“I wanted to work,’’ he told his colleagues, who have rejected offering
insurance to the “able-bodied” and childless men and women who are among
the state’s uninsured who could be covered by the Senate plan.
“Trust me, there are individuals that want to work but can’t work right
now,’’ he said. “Yeah, put politics aside, but open your hearts just a
tad bit.”
Others criticized the governor and House for assuming the federal
government won’t approve the plan unless they ask.
“It’s sort of like not taking your heart medicine because you’re waiting
for a heart transplant,’’ said Rep. José Javier Rodriguez, D-Miami. “We
have to deal with what Florida needs.”
Rep. Lori Berman, D-West Palm Beach, said: “It’s disingenuous to reject
these federal dollars for health care while requesting federal care for
other uses.”
The conflict now turns to how much lawmakers will spend in surplus funds
to soften the blow for hospitals that provide charity care for the
uninsured. Hospitals had relied on what is known as the Low Income Pool.
After warning Florida for more than a year that it was phasing out the
LIP fund, the federal Centers for Medicare & Medicaid Services announced
May 21 that the state would get only $1 billion of the $2.2 billion it
received last year. Hospitals warned that the lost revenue could reduce
services and staff at hospitals that serve the uninsured.
House and Senate leaders announced Friday they will begin conference
negotiations over the weekend to complete the budget by the June 30
deadline. Each has said the state will have to spend millions in general
revenue to offset the lost federal money.
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