To Expand or Not to Expand? That is the Medicaid Question!
By Greg Giordano
The gavel has struck and the Florida Legislature is now in session. As New Port Richey’s Vice Mayor Rob Marlowe commented last week by quoting Gideon Tucker: “No man’s life, liberty or property are safe while the legislature is in session.” While the late attorney Mr. Tucker may have had a cynical outlook on the legislative process, there is always a danger that any particular piece of legislation may not be quite as good a piece of public policy it would appear to be. As Hamlet agonized over the certainties of life and the unknown of death, an issue of perhaps equal import to potentially millions of Floridians is on the table in Tallahassee.
That issue facing lawmakers, a contentious issue no doubt, is the proposed expansion of the Medicaid program. As part of the Patient Protection & Affordable Care Act, the federal government is offering the state of Florida three years of fully funded Medicaid expansion dollars that could potentially cover millions of people now without health insurance. The approximately $24 billion are really Florida’s own dollars which would come back to the state to fund a service that is arguably a needed one.
Proponents point to the fact that for three years the tab will be fully covered by Washington. After three years the state’s share increases from 0% to 10%, a far cry from the over 40% the state normally pays for its share of Medicaid. Opponents point to the fact that the acceptance of federal dollars will expand the already gigantic Medicaid program, thus committing the state to its perpetuation far into the future. Given uncertain economic times, they are concerned if Florida will be able to afford providing the coverage after the initial three-year “cost-free” period is over.
As with any policy proposal one can see the merits of both sides. Sometimes what gets lost in the debate over policy and philosophy is the human factor. Every action that is taken by elected officials, whether at city hall, in the state capital or in the halls of Congress, ultimately impacts real people. A good lawmaker weighs the philosophical impact of a proposal against the “real life” impact it will have on the people they represent. That is why arguments over taxes resonant with the public. We all can see in the amount of our paychecks, the balance in our bank accounts, or the amount of money we have left in our wallets at the end of a pay period, the impact a tax increase will have. People with health care coverage may not be concerned with the expansion of Medicaid, for example. But those without any health insurance will definitely feel the impact of whatever decision is made by the Florida Legislature before the session ends in May.
A leading voice in favor of the Medicaid expansion is Representative Mike Fasano. He is prepared to go toe-to-toe with anyone who is not willing to provide health care coverage to the most needy of our state. There will be others who will stand with him and some who will not. The one certain thing is that this is an issue that will get a thorough public debate. Its fate should rise or fall on the merits of the issue. Hopefully Mr. Tucker’s fears will not be realized. And, hopefully, the answer will not leave Floridians, like Hamlet, wondering about their future.