Florida Senate panel's rejection of Medicaid expansion draws mixed reaction regionally

Rick Scott on Medicaid expansion

Expansion faces opposition in House.

Rick Scott supports Medicaid expansion

Permission to move Medicaid patients into private ...

TALLAHASSEE — A Florida Senate committee on Monday rejected Gov. Rick Scott’s suggestion to offer Medicaid coverage to about 1 million more low-income Floridians.

But Republican lawmakers still think billions of dollars could be available for care under President Obama’s health law. On Monday, they steered the conversation toward new plans providing vouchers for patients to buy private insurance.

State Sen. Joe Negron, R-Stuart, didn’t just oppose expanding Medicaid. One of his key goals, he said, is “to get out of the federal Medicaid system as we know it.”

“I think there is interest in rejecting a Washington plan and exploring a Florida plan,” Negron said Monday.

Negron’s Senate Committee on the Patient Protection and Affordable Care Act voted 7-4, along party lines, to reject the optional Medicaid expansion under Obamacare.

Southwest Florida hospital officials had mixed reactions to the vote.

Jim Nathan, president of the Lee Memorial Health System in Lee County, a public hospital system, said the state has an opportunity to insure many low-income residents who otherwise wouldn’t have access to medical care.

The Medicaid expansion population includes patients who could make up to 133 percent of the federal poverty level — $15,000 per person, or $26,000 for a family of three, according to health officials.

“Study after study shows that people with health insurance tend to be healthier and when they do get sick they have better outcomes,” Nathan said in a statement. “We strongly urge our legislators to drop their opposition to the Medicaid expansion and find a way to provide health insurance for Florida’s working poor.”

Jim Nathan, President/CEO, Lee Memorial Health System on NewsMakers 10-7-12.

Alan Levine, president of the Florida Group for the Naples-based Health Management Associates, said the Senate wants to take the federal money and create an insurance model.

“They are reaching for innovative solutions for coverage and I applaud them for this,” Levine said. “Hopefully the House of Representatives will come to the table and work with them on this so they can get it done this legislative session.”

Bruce Rueben, president of the Florida Hospital Association, said before the Senate subcommittee vote that the potential expansion of Medicaid in the state isn’t only good for patients being able to access medical care and have improved health, but an expansion would help offset reimbursement cuts that hospitals face from sequestration from the federal government.

Even though Scott said last month he would go along with the expansion, Rueben pointed out that nothing is done.

“This is a big journey for Republicans who have been so opposed to the expansion,” Rueben said. “All of these governors are saying ‘yes,’ but we haven’t heard from the Legislature yet.”

In Tallahassee on Monday, Negron laid out principles for a plan he will propose. First, he wants everyone to have some co-pay based on income level. That could be as low as $3.80 for an emergency room visit, he said.

He wants Florida Healthy Kids, which helps 5- to 18-year-olds get subsidized private insurance for $15-$20 a month, to expand to cover the new eligible populations. His plan also would include health reimbursement accounts, dollars set aside to reward patients for healthy behaviors that can be used for co-payments or medical costs not covered.

State Sen. Joe Negron, R-Stuart

He said he wants patients to take ownership of health plans, rather than feel dependent on the state. And he wants the entire Medicaid population eventually to receive a voucher they can use toward a plan of their choice.

Last week, the House committee tasked with the same expansion decision voted against drafting an expansion plan along party lines. State Reps. MaryLynn Magar, R-Tequesta, and Cary Pigman, R-Avon Park, were part of the majority that voted down the expansion.

House Speaker Will Weatherford, R-Wesley Chapel, bashed the expansion in his opening remarks for session last Tuesday.

Scott endorsed accepting the expansion for a three-year trial run — a stark turnaround from his anti-Obamacare rhetoric on the campaign trail and in his first two years in office.

In a news release Monday, Scott said he’s “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 Associated Press contributed to this report.