- Congressional Democrats are preparing to begin voting on the inflation deal this weekend.
- But the agreement does not include health care for people with incomes close to the poverty line.
- About 800,000 Florida residents will remain without insurance and the next attempt at coverage may not come until 2024.
When Congressional Democrats announced last year that they were preparing a massive spending bill to reshape America’s social safety net, public health advocates in Florida were optimistic there might finally be a way to cover more people.
However, their hopes were dashed last week. One of the many items that got to the bottom of the cutting room in the Democrats’ $740 billion inflation-reduction bill was a provision intended to bypass Republican lawmakers to expand Medicaid to nearly 800,000 Florida residents.
Health care advocates say the omission is a major blow to the uninsured in Florida, especially at a time when many are worried about a recession and residents are already facing rising costs for groceries, gas pumps and soaring rent bills.
“It’s definitely a missed opportunity, especially when it all comes down to inflation and its effects,” Scott Darius, executive director of the nonprofit health group Florida Voices, told Insider.
Florida is among 12 Republican-led states that refuse to expand Medicaid under the Affordable Care Act, known as Obamacare. By law, states pay 10% of the cost, while the federal government pays 90% of the bill.
Florida probably won’t have a chance to expand Medicaid until 2024 at the earliest. Die Befürworter des Gesundheitswesens in Florida und die Demokraten haben wenig Vertrauen, dass die Republikaner im Landtag ihre Position gegen die Expansion von Medicaid ändern werden, und hoffen daher, die Frage bei den Wahlennenen diren emmön aufen ability.
“Having a ballot is the best thing we have to push Medicaid expansion,” Senator Shiffrin Jones, a Democratic senator for Miami Gardens and a member of the Senate Health Policy Committee, told Insider.
“That should be our top priority, but Republicans have shown us time and time again that they don’t care what makes sense,” Jones added. “They are interested in what feeds their base.”
In 2021, President Joe Biden’s $1.9 trillion coronavirus rescue package attempted to improve the Medicaid deal by covering state costs for two years, but Florida did not stick to it. Republican Governor Ron. DeSantis’ office told the Washington Post in March 2021 that he “remains opposed to Medicaid’s expansion in Florida.”
The governor’s office and several other GOP leaders in the state legislature did not respond to Insider’s questions about whether conditions like the recession could change their stance on Medicaid expansion.
Republicans have raised concerns about covering more health care costs, citing concerns that the federal government may one day recover Medicaid payments.
House Speaker Chris Sprouls, a Palm Harbor Republican, said he believes Medicaid should only go to the most vulnerable populations and not rely on income, he told the Orlando Sentinel in March 2021.
Under Obamacare, individuals who earn $13,590 or less per person or $27,750 for a family of four qualify to enroll in Medicaid. This raises objections from Republicans because it does not take into account disability or work status.
Reverend Vanessa Tinsley, executive director of Bridge to Hope, a Miami-based community organization whose services include a food program, said the narrative about people on Medicaid is incorrect. Many of the clients you serve have college jobs and degrees.
“It’s not about working hard — we have this here — but they’re working hard in low-paying jobs,” she said, adding that despite raising the minimum wage, Florida has not kept pace with rising rents. She said a major medical problem could evaporate or increase the savings.
The US House of Representatives version of Biden’s agenda cut the price by more than half
For more than a year, Democrats in Congress have searched for ways to bypass GOP lawmakers in states that reject Medicaid. An estimated 4 million uninsured people nationwide could join Medicaid if all states expanded the program, according to a federal government report compiled by the Department of Health and Human Services.
The US House of Representatives’ $2 trillion Better Rebuilding Act, passed in November 2021, provided a solution to the Medicaid loophole. It would have covered the full cost of private health insurance premiums for people who earn near the poverty line.
But that provision was removed among many to create the Inflation Reduction Act, even though the bill retained other health policies on drug prices and private health insurance for high-income people who would not qualify for Medicaid.
The bill can still change. Democratic Senator Raphael Warnock of Georgia plans to introduce an amendment to help people who do not have access to Medicaid. The amendment will be introduced during a “Voting in Rama” session, an extended session of amendment votes that can end with changing the final bill. The Senate is considering an inflation deal that begins on Saturday.
Florida Voices for Health is working with Southerners to expand Medicaid to lobby Congress this week in support of the Warnock Amendment.
But conservative Democratic Senators Joe Manchin of West Virginia and Kirsten Sinema of Arizona have been wary of raising the price of the legislation. A bipartisan estimate by the Congressional Budget Office found that the Medicaid idea of the Rebuilding Better Act could cost the federal government $125 billion.
We may have to get creative.
Without a federal solution or an immediate vote, the fate of Medicaid falls in the hands of state legislators or voters.
Bridge to Hope’s Tinsley said she was “terrified” of the recession because she’s already seeing people living on the edge. She knows families whose parents can’t marry because their kids won’t be eligible for Medicaid, people who skip essential medications, or parents with asthma who can’t afford health insurance and have to borrow their children’s inhalers.
“The people in my grocery line were benefactors and volunteers,” Tinsley said. Our resources are shrinking.
She said the inability to afford medical care worsens people’s living conditions. She added that many people across Florida who need to cut back on spending can only do so by reducing their grocery bills. Oftentimes, cheaper food is also less healthy, and this leads to problems such as diabetes and high blood pressure, which in turn increases people’s healthcare costs.
DeSantis is a candidate for re-election in Florida and is expected to win as Florida’s Republicans outnumber Democrats in the state by 220,000. Both Democrats running the nomination in the August 23 primaries to oppose it — Representative Charlie Crist and Florida Commissioner of Agriculture Nikki Fried — support the Medicaid expansion.
Jones faces a major opponent on August 23. If reelected, he said, he plans to file a Medicaid expansion bill. However, on this tour, he said he wanted to try to see if there was a way to reach a bipartisan agreement, as some other GOP-led states have done — especially after hospitals and health insurance companies united behind the effort.
“Maybe we need to get creative,” he said.
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