The American people are taking Medicaid expansion into their hands. It should be a lesson for Florida's leaders.
In the recently concluded elections, voters in three conservative states — Utah, Idaho and Nebraska — said yes to Medicaid expansion. All three of those states were carried by Donald Trump in 2016 by double-digit margins.
In two other Republican states where legislatures had voted for Medicaid expansion — Kansas and Maine — Democratic governors were elected. Maine voters also passed a resolution last year endorsing expansion, but the Republican governor at the time declined to follow it.
And Virginia approved Medicaid expansion earlier this year.
In Nebraska, expansion means $1.3 billion in federal funds for the state during the first three years, a major economic impact. In fact, expansion would produce more in local and state revenues than it would cost, according to a study by University of Nebraska-Kearney business and economic professors.
In Idaho, Medicaid expansion was backed by hospitals that provide charity care to poor residents who don't have insurance.
States pay for their share of Medicaid expansion in various ways. New Hampshire uses a tax on alcohol. Virginia, Oregon and Colorado place fees on hospitals, figuring Medicaid expansion helps their bottom line by removing unpaid care.
In Utah, voters agreed to fund their plan by adding a minimal amount to the state sales tax, just 1 cent in a $10 purchase. Voters approved full expansion after the Utah legislature only approved partial expansion.
A referendum in Florida, even if it is a straw vote, might help members of the Legislature determine whether their constituents want Medicaid expansion. Florida runs a tight Medicaid program based on the managed care model. Sometimes reimbursements are so low physicians decline to participate — one of the potential drawbacks to expansion.
Another problem that would need to be solved before expansion: The federal government pays at least 90 percent of the cost of Medicaid expansion compared with about 60 percent for traditional Medicaid. Still, that money would need to come from somewhere, and the deficit proves we need to be thrifty.
A new report from the nonpartisan Center for American Progress concludes Medicaid expansion would save the lives of 2,323 Floridians per year through early cancer diagnosis and better care of opioid patients, among other methods. Expansion also could be an economic boon to Floridians by reducing family debt, reducing credit debt and savings to local communities from public safety.
Experience with other states proves fears of cost are not the real reason that Florida's leaders, mainly in the House, refuse to expand Medicaid. It's ideological rigidity. Why else could leaders look the other way while their constituents needlessly suffer?
More bipartisan action is needed to bring down the overall cost of health care such as prescription drug prices, and in this arena, the Trump administration has been moving in the right direction.
REPRINTED FROM THE PANAMA CITY NEWS HERALD
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