We are a compassionate state and nation that ensures lifesaving care is available to everyone. Thanks to the federal Emergency Medical Treatment and Labor Act signed by President Ronald Reagan, no one can be denied hospital emergency care.
However, we all know that using emergency rooms for primary care wastes money.
Chief among the proposed solutions to this waste is the federal government’s plan to expand Medicaid.
Traditional Medicaid is a joint federal state program for low income people with federally imposed benefits and defined coverage groups. In Florida, Medicaid is 31 percent of the state budget, or $23.3 billion per year for 3.74 million people.
That’s roughly $6,500 per enrollee. Medicaid expansion would add more enrollees with the federal government picking up 90 percent of the cost.
However, there is no guarantee those funds will continue past this decade. With its continuing reckless budgets and spending initiatives, unsustainable entitlements will likely be the first in line for cuts when Congress finally makes the hard choices. This is just too risky for Florida. Today, even a 1percent shift in the match would cost Floridians about $180 million every single year.
We know from experience that federal partnerships can be unreliable. They committed to pay 50 percent of the Everglades restoration and 40 percent of special education under the Individuals with Disabilities Education Act, but in both cases, the federal government has met less than half of that promise. The money we do receive comes with strings, making these funds far from “free.”
Most important, we know Medicaid doesn’t serve patients well.
Researchers in Oregon conducted the only scientific study of Medicaid in the country.The study found that Medicaid coverage had no statistically significant effect on recipients’ clinical health, compared with those without Medicaid. In short, Medicaid patients were no better off than the uninsured.
The University of Virginia also studied 893,658 major surgeries over a fiveyear period and compared the clinical outcomes, accounting for all factors except coverage type. They found that Medicaid patients were 93 percent more likely to die before leaving the hospital than patients with private insurance, while uninsured patients were 73 percent more likely to die than patients with private insurance. In short, Medicaid patients were worse off than the uninsured.
The Florida Senate has proposed a plan to expand coverage using (promised) federal dollars that they call market based.
Sadly, it is pure, plain old Medicaid expansion. It’s the same Medicaid expansion group mandated by Obamacare. It uses the same federal dollars. And it provides the same Medicaid services.
The Senate plan is unrealistic. While this proposal may contain a few creative, freemarket elements, the federal government will not approve them. Other states have already asked for federal approval of these ideas and they were denied. This gambles with people’s lives.
If the plan is not approved within six months, those people will see their coverage terminated, making the state as unreliable and unpredictable as the federal government.
The Florida Senate wants to expand a government program proven not to work, with money that taxpayers don’t (or won’t) have, to people who may not be eligible in six months, contingent upon a federal waiver that is unlikely to be approved. Yet, some people can’t believe the Florida House thinks this is a bad idea.
This session, the House proposed several bills that encourage transparency and consumer choice. They include ideas that encourage direct primary care models, assist state employees to be better informed about their health care options, and give more regulatory freedom to lowercost health care providers like ambulatory surgical centers and recovery care centers.
We passed health care workforce reforms in 2014, designed to increase access to needed care, which the Senate declined to pass. Before that, we passed an alternative coverage plan in 2013 that the Senate refused to even debate.
Expanding Medicaid is too risky for Florida and it doesn’t provide better outcomes for those who are currently uninsured. We want everyone to have access to highquality health care, but expanding the federal Medicaid program is not the answer.
Thomas Jefferson commented long ago, “The whole art of government consists in the art of being honest.”
As members of the Florida House Polk County delegation we support an honest position on this important issue and we stand together in opposition to the Medicaid expansion policy option for Florida.
[ State Reps. Ben Albritton, RWauchula, Colleen Burton, RLakeland, Neil Combee, RPolk City, Mike LaRosa, RSt. Cloud and John Wood, RWinter Haven, all represent Polk County in the Florida House of Representatives. ]