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Florida Panel Kills Medicaid Expansion, but Debate Continues

By Jane Norman, CQ HealthBeat Associate Editor

March 12, 2013 -- Turbulence over Medicaid continues in Florida, where state lawmakers have killed an expansion plan supported by Republican Gov. Rick Scott, but some legislators continue to press for an alternative solution to cover uninsured adults.

A Senate select committee on the federal health care law voted 7–4 along party lines Monday against expanding Medicaid as envisioned by the health care law (PL 111-148, PL 111-152), the Miami Herald reported. Last week, a House panel also rejected expansion.

In February, Scott startled fellow conservatives when he announced that he favored a three-year expansion of Medicaid to cover single adults in Florida, though at that point the program would have to be evaluated before a decision was made whether to continue it. Scott is among a group of Republican governors who have reversed themselves on the health care overhaul and accepted the expansion.

But it was always up to Florida’s lawmakers to concur, and signs are that some of them want to explore how the state could still receive federal funding to cover the uninsured without taking part in the expansion. The state Senate committee said it wants to pursue an unspecified “third option,” and GOP state Sen. Joe Negron is working on a “Florida solution,” under which the state would buy private insurance policies with expansion funds, the Herald said.

The approach could be to allow adults to be covered in the Florida Healthy Kids program, the state’s public–private program for low-income children, lawmakers said.

Arkansas officials are considering something similar. Gov. Mike Beebe, a Democrat, has said that Health and Human Services Secretary Kathleen Sebelius has told him that Medicaid expansion funds could be used to place low-income citizens in private insurance plans.
Florida Senate President Don Gaetz, a Republican, said in a statement that the House and Senate will work together to explore how to provide private health insurance options for low-income people and replace the Medicaid program. “We welcome the governor and others concerned about this issue to join us in getting Florida out of Medicaid as it has existed in the past,” Gaetz said.

The Senate Democratic leader, Chris Smith, said in a statement that Republicans are endorsing the Medicaid expansion by moving to use the federal Medicaid dollars, even if they’re taking a different approach.

“Whatever name they opt to give the program, the bottom line is that money allocated by the federal government for Medicaid expansion will be the mechanism,” Smith said in a statement. “In the Senate, the remaining question is no longer ‘if,’ but ‘who.’”

Scott said in a statement that “I am confident that the Legislature will do the right thing and find a way to protect taxpayers and the uninsured in our state while the new health care law provides 100 percent federal funding.”

The Centers for Medicare and Medicaid Services would have to approve any plan to change the way the state receives and uses Medicaid funds.


  • Far to the north in Maine, the Portland Press Herald reported Tuesday that Republican Gov. Paul R. LePage and Democratic lawmakers appear to be nearing consensus on a Medicaid expansion in that state, with LePage saying he is open to expansion. The liberal-leaning Maine Center for Economic Policy and Maine Equal Justice Partners issued a report saying expansion would extend health insurance to more than 69,000 state residents, most of them working adults. It would also create 3,100 new jobs and stimulate $350 million a year in economic activity, the report said. 
  • The Topeka Capital-Journal reported Tuesday that a new coalition of groups encouraged by the sight of other Republican governors taking action is pushing Republican Gov. Sam Brownback and lawmakers to expand Medicaid. 
  • Arizona Gov. Jan Brewer, also a Republican, was scheduled Tuesday to announce details of her plan for the state’s Medicaid expansion
  • The Utah House of Representatives approved a measure that would ban Medicaid expansion, the Deseret News reported Monday. Republican Gov. Gary R. Herbert hasn’t yet announced what he will do.

Jane Norman can be reached at [email protected].

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