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Fla. House, governor clash on Medicaid expansion

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TALLAHASSEE, Fla. (AP) — Gov. Rick Scott, R, slammed a Florida House proposal Thursday that would pass up billions of dollars in Medicaid expansion funding.

The House proposal calls for Florida to set up a much smaller, state-financed program for helping uninsured residents get coverage.

The House proposal relies entirely on $237 million in state taxpayer funds and would not tap into an estimated $51 billion dollars in federal aid available under the Patient Protection and Affordable Care Act (PPACA) over the next decade.

The Obama administration wants to make Medicaid available to Americans earning up to 138 percent of the poverty level. The U.S. Department of Health and Human Services (HHS) has been offering Florida enough PPACA Medicaid expansion money to help enroll about 1 million uninsured residents in Medicaid plans.

The Florida House proposal — based on a program developed by former House Speaker Marco Rubio, who is now a U.S. senator — would provide access to coverage for the 115,000 state residents who earn up to 100 percent of the federal poverty level.

The state’s Florida Health Choices program would provide low-income residents with state money that they could use to buy private health coverage through the new PPACA health insurance exchange system.  

“The House’s plan will cost Florida taxpayers on top of what they are already taxed under the president’s new health care law,” Scott said in a statement. “This would be a double-hit to state taxpayers.”

Scott made an about-face decision earlier this year saying he supported Medicaid expansion because it was the compassionate, common-sense approach, but he’s said he’s open to alternatives after committees in both the House and Senate rejected expanding Medicaid. Scott signaled Thursday that he would support a Senate plan proposed by Sen. Joe Negron “because it protects both state taxpayers and the uninsured in our state.”

Negron’s bill would still tap into billions of federal dollars and use those funds for vouchers so patients could purchase private health insurance. His plan would use Florida Healthy Kids, an organization he says has a strong record in the state.

But House Republicans made it clear that they would not accept any health plan that relies on federal funds, worrying that if they expand the program the federal government will not make good on its promise to fund it.

The federal government has promised to foot the entire bill of Medicaid expansion for three years and cover 90 percent of the cost after that.

The federal government now pays about half of the tab for the state’s Medicaid program.

“Maybe it’s the $16 trillion deficit that gives me pause,” Weatherford said. “The federal government is more interested in expanding a flawed program. We think this is an opportunity to lead the health care debate not just in Florida, but to take a new idea for people who don’t have care and do it in a more responsible way. I don’t think we should be relying, long term, on a federal solution to our health care needs in the state of Florida.”

The House proposal is similar to plan in the Senate backed by Sen. Aaron Bean, R-Fernandina Beach, who also wants to rely on state dollars. But the House plan is more comprehensive and would offer coverage to disabled adults and adults with children. Most of the plans would provide low-cost preventive and primary care visits, subsidized by state funds.

Negron said he still preferred the Senate proposal, but he praised the House effort as a “well-thought out plan” to provide coverage for some uninsured residents.

“I think it’s a step in the right direction,” Negron said.

Angry House Democrats have said finding an affordable way to expand health coverage is still do-able even though the Legislative session is past the midpoint.

House Democrats felt so strongly about the health care decision that they initially agreed to withhold their support for the House’s proposed $74 billion budget to signal their strong advocacy for action. But shortly after the House proposal was released, House Democratic Leader Perry Thurston said he went to fellow Democrats and said they should vote on the budget as they deem appropriate.

Thurston, however, criticized the House proposal.

“The problem is that they’ve been dragging their feet, they still don’t want to accept the money that’s there,” Thurston said. “Other states will take it. As a donor state, we’ll continue to give, give and we won’t receive for our residents. And it’s because it’s the most needy residents in the state of Florida.”

Associated Press writers James Rosica and Bruce Schreiner in Tallahassee contributed to this report.