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Regulation and Compliance > State Regulation

Price of Florida PPACA efforts adjusted downward

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TALLAHASSEE, Fla. (AP) — Florida economists on Thursday came out with a new price tag for the Patient Protection and Affordable Care Act (PPACA) that is dramatically lower than the one cited earlier this year by Gov. Rick Scott, R.

Economists are now projecting that it would cost Florida taxpayers about $5.2 billion over the next decade to pay for the changes.

The total amount includes $3.5 billion to expand Medicaid coverage to nearly 1 million Floridians as well as other requirements under the law. But that expansion plan is in limbo after House Speaker Will Weatherford came out in sharp opposition this week.

State economists also now project that Florida would draw down in excess of $51 billion in federal aid over the next 10 years if the state expanded Medicaid.

Scott, a Republican, is now in favor of expansion. But earlier this year he contended that the expansion — and other elements of the PPACA — would cost state taxpayers nearly $26 billion over 10 years. Like other Republican officeholders, Scott had sharply criticized “Obamacare.” Several other Republican governors have recently said they’ll go along with expanding Medicaid because of the infusion of federal dollars and because they think it makes fiscal sense.

There are several reasons for the big swings in estimates, but the primary reason is that Scott relied on a forecast that assumed Congress would change the federal law and reduce the amount of money that the state would receive to expand Medicaid.

Scott now supports Medicaid expansion for the first three years when the federal government is scheduled to pick up 100 percent of the cost. The state’s share of new Medicaid costs would then rise over several years to 10 percent.

But the governor made it clear on Thursday that Medicaid expansion is not on his list of top priorities for the current legislative session.

“I let everybody know my position with regard to Medicaid expansion,” Scott said. “My position I think is the right position for Florida families. The legislative process is just starting. Hopefully they will do the right thing.”

Weatherford has criticized the expansion as a “social experiment” destined to fail. He also contends the federal government will cut the funding.

Medicaid is a $21 billion safety net program for the poor in Florida and currently the federal government picks up about 58 percent of the cost.

Obama’s health care law called for states in 2014 to expand eligibility of Medicaid to those making up to 138 percent of the poverty level, or $31,809 for a family of four in Florida. The changes would also require adding people who are below the poverty level but not eligible for Medicaid such as childless adults.

The U.S. Supreme Court ruled last summer that expansion of Medicaid is not mandatory and that states can opt out if they choose.

The state has been trying to gauge the full financial impact to state taxpayers of both expanding Medicaid as well as paying higher reimbursement rates to health care providers.

For example, state economists have tried to determine how many years it will take for all those eligible for Medicaid to actually enroll. The economists have also assumed that nearly 151,000 people who are just above the poverty line but now rely on private insurance would drop coverage and switch to Medicaid.


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