Florida Medicaid Debate Threatens to Shut Down Government

Republican Sen. Don Gaetz (R-Fla.) is counseling his fellow state lawmakers to, in the words of former Florida Senate President Jeff Atwater, “never fear the debate” as the Legislature struggles to settle a dispute that if unresolved could shut down all but the most essential state services in Florida.

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A war of words over one of the most contentious phrases in 21st century political lexicon, “the expansion of Medicaid,” has pitted Gov. Rick Scott (R) against Democrats and even some of his fellow Republicans.

It has also blocked approval of the state’s budget for the fiscal year that begins July 1.

The disagreement became so severe that lawmakers in the Florida House and Senate closed their offices and went home April 30, tired of wrangling with Gov. Scott and each other over whether Florida should expand its Medicaid program under Obamacare.

The Medicaid debate in Florida is much more than a typical partisan squabble over Obamacare. It opened the door to debate over healthcare spending in Florida, and that deadlocked negotiations over the next fiscal year’s budget.

Beyond the budget, there are some very human consequences to be paid if there is no resolution. Florida, as the Tampa Bay Times reported, has the second-highest number of low-income, uninsured adults in the nation. Only Texas has more.

Adding to the pressure is the Obama administration decision to end funding for the Low Income Pool (LIP) program, which was set up in 2005 to cover low-income people in Florida.

When negotiations broke down and cooler heads no longer prevailed at the end of April, the Florida Senate wanted to go with a Medicaid expansion plan tied to private insurance, an idea that was rejected by the House.

They are scheduled to start hammering out some kind of agreement during a special session in June.

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Gaetz does not see disagreement as a bad thing, especially in politics. He said the state and federal governments that were established with three branches of government, including a legislative branch with two bodies of lawmakers, were “purposefully built with tension in the system.”

There is more than enough of that to go around in Tallahassee.

“The problem now is that the debate has turned sour and ugly. Some of the advocates have become petulant, even intolerant. Solutions have given way to sloganeering,” Gaetz said.

“The personal respect and trust between legislative leaders and between the Legislature and the governor, which is the WD-40 that otherwise eases the way to compromise, is missing this year. In other words, Tallahassee at its worst is taking on the identity of Washington at its best,” he added.

Gov. Scott blames Washington for the mess in which the state capitol of Tallahassee finds itself.

He filed a lawsuit in April, which accused the Obama administration of trying to force Florida to expand its Medicaid program by ending the LIP healthcare program.

“If the Obama administration can arbitrarily and capriciously end one healthcare program in Florida, likely leaving our state taxpayers to foot the bill, it would be irresponsible to further obligate state taxpayers by going deeper into Obamacare with an expansion of Medicaid,” Scott said.

“Moreover, the Obamacare expansion scenario contemplated at the state level in Florida would stick Florida taxpayers with a $5 billion bill over 10 years, at minimum. There is no true ‘free money’ for states through Obamacare, as we can plainly see from mounting cost estimates in states across the country.”

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Scott also accused of the Department of Health and Human Services of purposely dragging its regulatory heels, putting low-income Floridians at risk.

It would be a mistake to believe that legislative tempers have cooled along with the heels of Florida Democrats and Republicans.

Senate Democratic Leader Arthenia Joyner said May 6 she was “fed up” with Scott and called on him to “stop revising history.”

“There is a good and reasonable Senate healthcare plan still on the table, incorporating the principles you claim as a ‘conservative’ that you’ve done everything to thwart and not one thing to support. It saves Florida taxpayers and businesses money. It covers the uninsured. And it’s self-sustaining,” she said.

“So don’t claim feigned outrage at the federal government’s decision to abide by the agreement struck one year ago. And don’t claim you now have the welfare of the low-income families in this state as the reason for your finger-jabbing at Washington. Because one million uninsured Floridians you callously blocked from healthcare expansion are testament to the contrary.”

As bad as it’s been so far, June could be the stormiest month of the 2015 calendar for the Florida Legislature.

The state’s budget expires June 30. The debate over Medicaid expansion and healthcare spending has blocked passage of a new spending plan. If there is no resolution, there will be no budget.

Scott is planning ahead. He has ordered state agencies to prepare shutdown plans, has used the phrase “continuation budget,” which would be something new for the state of Florida, and is urging the Legislature, when it returns in June, to treat the Medicaid and budget debates as separate as apples and oranges.

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However, even if the Legislature approves a budget separate from the healthcare and Medicaid expansion debates, that still leaves the expansion of Medicaid as festering as any open wound in a hot, humid Florida summer.

“Let there be no doubt, the Obama administration’s end to the LIP program in states is the new battlefront in states’ fight against federal overreach,” said Scott. “They want us to take on more of Obamacare. They want us to adopt their policy the way they want us to – or else. This is The Sopranos.”

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