To Tallahassee and Back: Medicaid Expansion; Let’s “Get ‘r Done!”

At the risk of belaboring a point, I felt I would be remiss if I did not follow-up on the subject of last week’s blog post: The question of Medicaid Expansion.  Or, should I say, the Medicaid Expansion that took a second body blow this week in Tallahassee.  Following last week’s defeat in a House committee to not pursue the expansion of the federally funded, but state-run health insurance program for low-income Floridians, the Florida Senate followed suit this week and drove an upper chamber nail into the coffin of the proposal with a nay vote of its own.  However, the legislative session is only in its second week and there remains time to “get ‘r done.”

Although few would think Larry the Cable Guy is a fitting person to quote in a blog about such a serious public policy issue, the message of his famous phrase is quite clear.  The legislature does have the opportunity to get the job done, if it chooses to do so.  And that is the rub.  The will of leadership and the will of the membership are not always one and the same.  Representative Mike Fasano, arguably the most vocal legislative advocate for the proposed Medicaid expansion, is standing true to his commitment to speak on behalf of the uninsured Floridians who would benefit if these dollars are accepted.

On March 12 he joined a group of hospital executives to denounce the decision in both legislative chambers to turn down the federal dollars that would help over one million Floridians receive health care.  Right now hospitals are required to provide care through emergency rooms that would, in many instances, be better provided by a primary care physician.  Unfortunately those without insurance go to emergency rooms for treatment because they may not have anywhere else to go.  Despite the growth of community health centers, hospitals are often the first choice for those desperate for medical care.  The cost of those services, although borne by the hospitals, ultimately comes back to the average citizen through higher medical costs overall. 

On March 14 a different group of people will gather in Tallahassee for much the same reason as the hospital execs.  Representing the rank and file health care workers, doctors, those in need of care and the various advocacy groups in favor of the expansion, the message will be the same.  Heading the event will be Representative Fasano beating the drum with the message to accept the Medicaid expansion now.  Representative Fasano’s adeptness at working with all groups will be evident as he does his best to convince his colleagues that this is the right thing to do for now and for the future.

The argument for the expansion is not merely rooted in a belief that people who need medical care should get medical care.  It is also an economic argument that has a solid foundation.  It is folly to not accept the proffered federal funds that are Florida’s own dollars that have already been collected and sent to Washington.  In a very real sense, taxpayers have already funded the expansion; policymakers just have to agree to terms with the feds to get the money back.  Opponents argue that alternatives should be explored, which is well and good.  Perhaps a better plan will emerge before the session ends on May 3rd.  With about seven weeks in the session, if the Medicaid expansion is not the answer then the legislature needs to find one that is doable.  If not, those dollars will be snapped up by some other state that is all too willing to take Florida’s money and put it to good use for its own residents.

Will the Florida Legislature “get ‘r done?”  Representative Fasano will do all that he can to see that it gets done.  The burden will not be easy, however, and the load will not be light.  What do you think about this?  Should the expansion of Medicaid be given the green light to go forward?  Should our lawmakers look at alternatives to expanding Medicaid and, if so, what would those alternatives be?  Should the whole concept be scrapped and allow our dollars to go somewhere else?  Opinions are many and diverse.  What is yours?  Please post your thoughts and let me know!