TALLAHASSEE — The decision to offer Medicaid coverage to roughly 1 million Florida residents under the federal health law is triggering partisan bickering amid competing proposals to pass up billions of federal dollars entirely or to accept the money, but funnel it into private insurance.
A week after House and Senate committees in the Republican-led legislature vetoed expanding Medicaid, two very different Medicaid expansion proposals are emerging in the Senate.
Sen. Joe Negron wants to offer residents vouchers to purchase private insurance. But it's unclear whether fellow Republican lawmakers will accept federal dollars to pay 100 percent of the program's costs for three years or shun the offer and rely on state dollars. Under President Barack Obama's health care law, the federal government would pay the entire cost of Medicaid expansion for three years, with the federal share gradually dropping to 90 percent.
Negron said he's confident his bill is laid out in a way that would qualify for funds under The Affordable Care Act. He hopes to have a program ready for enrollees beginning in October. The majority of the residents newly eligible for coverage are childless adults.
“The money that is available is paid for by taxpayers of Florida. I voted against expanding Medicaid. I don't support doing it that way,” Negron said today. “We don't want to do it the Washington way. We want to do it the Florida way.”
Republican Gov. Rick Scott is already voicing support for Negron's proposal. Scott said it is in line with his desire to helping the state's uninsured while it is 100 percent federally funded.
“I'm confident that we have enough time left during the session that the Legislature will do the right thing,” Scott said.
The Stuart Republican lawmaker wants Florida Healthy Kids to oversee the program, saying it has a good track record with the state and strong doctor participation. Insurers under Negron's plan would be required to spend 85 percent of their funds on health services — a measure that protects for-profit companies from scrimping on patient care.
The Senate Appropriations Committee is expected to take up Negron's proposal Thursday.
Meanwhile, Sen. Aaron Bean wants to pass up the free federal dollars and instead use state funds to help residents pay for a basic insurance plan. Bean and several other conservative lawmakers have spoken out against the so-called “Obamacare” law, saying the federal government can't afford the money its borrowing and they don't want Floridians to contribute to the federal government's lack of fiscal sobriety.
Bean is slated to present his proposal Wednesday to the Senate Health Policy Committee. Lawmakers have until early May to pass a proposal and send it to Scott.
Both plans would require residents to pay premiums and co-pays.
Negron's bill doesn't go into details of co-pays and premiums but he said federal regulations allow modest co-pays of around $3.80 for a hospital visit for those living below 100 percent of the poverty level and higher co-pays and deductibles, similar to what the private sector charges, for those living between 100 and 138 percent of the poverty line.
Scott, a vocal critic of the Affordable Care Act, made headlines last month when the Republican made an about-face decision to support Medicaid expansion for three years as long as the federal government pays the entire bill. But he recently said he's open to alternatives.
A House panel is also considering an alternative plan to Medicaid expansion but details are still being fleshed out. Republican House leaders have been skeptical about whether the federal government will actually live up to its promise to fully fund the program for the first three years.
House Speaker Will Weatherford said that while House Republicans are dead set against Medicaid expansion, he's not ruling out an alternative plan. But he said he's not enthusiastic either.
“We're not saying that we would never take any federal money under any circumstance. But (what) we are saying is that someone has to show certainty that long term you can rely on what the federal government is telling us is going to be there… They want us to get used to $6 billion or $7 billion of investment and after three years kind of hope they are (going to) continue to fund it.”
Republican Rep. Mike Fasano called the proposal to turn down federal funds a cop out and criticized fellow Republicans for being too afraid of far right-wing constituents to make a sensible decision.
“They are so afraid of those in the far right of the party of taking federal dollars that they'll sacrifice our teachers and our seniors and persons with disabilities so they won't get in trouble with the far right,” he said.