The Republican-controlled Florida House on Friday passed its plan to provide health coverage to about 115,000 of the state's neediest residents but bypassed tens of billions of federal dollars available under the Affordable Care Act.
The bill's passage now sets up a standoff between the House and Senate in the final week of the legislative session. If neither side blinks, a health insurance overhaul could well be over till next year, quashing one of Gov. Rick Scott's priorities.
House Speaker Will Weatherford has said there's “plenty of time” and he's not worried. The legislative session ends next Friday; it's too soon to tell whether Scott would call a special session to discuss the issue.
The vote was 71-45, with Republican Sen. Mike Fasano joining the chamber's 44 Democrats.
The House's less-comprehensive plan offers coverage to one-tenth of the 1.1 million Floridians that would be covered under a bill by a Republican senator. That bill is favored by Scott, House Democrats, and a mix of medical, business and labor groups.
House Republicans have been adamant about not accepting federal funds tied to President Obama's Affordable Care Act, having said it will contribute to the administration's deficit spending.
The Obama administration has sought to offer health insurance to more Americans by extending the Medicaid eligibility levels to those making up to 138 percent of the poverty level.
But the House plan only addresses residents making at or below 100 percent. That's roughly $11,000 a year for a single person and about $19,500 for family of three.
The House plan would use $237 million in state funds to give recipients $2,000 a year to choose their own private insurance plans. The plans would require a $25 monthly premium and likely have high deductibles, which Democrats said many families would not be able to afford.
In contrast, House members covered by the state insurance plan spend $8 a month.
“There's very little you can buy,” said Rep. Mia Jones, D-Jacksonville. “This population will not be able to take this product that has been crafted for them and not be able to do anything of value with it.”
House Democratic Leader Perry Thurston warned that members were missing a chance for bipartisanship, noting the Senate had already put aside their differences.
“We have a governor who has disagreement with the president of the United States but they came to a bipartisan resolution and put aside those differences,” Thurston said. “Why? Because of the importance of saving lives.”
After about five hours of discussion Thursday, the House shot down an amendment that would bring its proposal in line with the Senate.
The Senate plan, sponsored by Republican Joe Negron, would take more than $50 billion from the federal government over the next decade and give it to an estimated 1.1 million residents in the form of vouchers so they could purchase their own private health insurance. Florida Healthy Kids would oversee the program.
House Republicans have urged fiscal responsibility in only offering coverage to those perceived as the most vulnerable of the estimated 1.1 million, including working parents, single moms and disabled adults.
“We're not going to cover working adults who don't have that responsibility of families,” said Rep. Gayle Harrell, R-Port St. Lucie. “Perhaps someday that might happen.”
She said the state has a responsibility to “make sure we have a safety net for those that cannot take care of themselves and that's truly what Medicaid was designed to do. We want to offer them more than Medicaid.”
Disabled adults are already covered under Medicaid but the feds pay the state a matching rate of roughly 50 percent.
The Obama administration is offering to cover those newly eligible for Medicaid under the federal health law at a more generous rate, paying the entire bill for three years and 90 percent after that.
The House and Senate rejected a straight-out Medicaid expansion early in the legislative session, saying they did not want to expand an already broken program.
Republican Rep. MaryLynn Magar of Hobe Sound said the House plan is far better than Medicaid. She said it will allow recipients “take control of their own medical coverage” to choose their own plans and “see the doctor that they want to see.”