Today was the deadline for states to decide whether to set up their own health insurance exchange or let the federal government do it. Like 19 other Republican-led states, Florida decided, for now, to let the Feds do it. (They can change their mind at a later date, with approval of the Legislature and the governor.)
Given where we are today, this is probably the best they can do for now. As recommended by Florida CHAIN (Community Health Action Information Network), a statewide consumer health advocacy organization:
As a result of Florida leaders’ resistance to the ACA and inaction over the past two years, the state has not completed the planning or invested the resources needed to develop and launch a State-Based (or even a Partnership) Exchange by next October. Therefore, a Federally Facilitated Exchange should be established to serve Floridians, at least until Florida demonstrates that it can meet the requirements of the law and run their own Exchange with stakeholder and public input.
States also have to decide whether to expand Medicaid, which is a federal-state partnership, to a federally-mandated level in order to provide insurance for their uninsured. This is because the Supreme Court declared the provision of the ACA that required states to provide that coverage unconstitutional.
Here’s the deal: If a state agrees to expand coverage by increasing the income limit for the program to 138% of the Federal Poverty Level (individuals up to $15,400 and a family of three up to $26,300 based on the 2012 FPL) starting January 2014, the federal government will pay 100% of the cost for the first three years, and 90% thereafter.
If Florida agrees, according to “Obamacare: Or How I Learned To Stop Worrying And Love The Affordable Care Act” in today’s Naples Florida Weekly:
The notion is that over time roughly half of the 4 million uninsured or underinsured people in Florida will join Medicaid, and half will use a health insurance exchange.
In the program’s first three years alone, the federal government will spend at least $3.2 billion and as much as $4.78 billion while Florida taxpayers pay little or nothing, according to projections by the Florida Hospital Association.
In a report issued last month, the association strongly recommended embracing the federal plan, “which is estimated to expand coverage to 32 million individuals at a cost of $940 billion over 10 years (2010 to 2019).”
Here are some additional facts from Medicaid Expansion and the Affordable Care Act in Florida, by Florida CHAIN (Community Health Action Information Network), a statewide consumer health advocacy organization:
- The majority of newly Medicaid-eligible Florida adults are employed. They include workers in the areas such as retail, food preparation, tourism/hospitality and other service industries.
- The health coverage provided to Florida workers under Medicaid expansion would be a fully subsidized employee benefit, worth an estimated $14.3 billion to their employers over 10 years.
- Expansion will cost the state an estimated $2.1 billion over the next 10 years, increasing the state’s share of the Medicaid budget by only 2%, while drawing down $20.3 billion in federal funds.
- Medicaid expansion will create an estimated 65,000 new Florida jobs in the first 6 years alone.
The Florida Legislature and governor have to decide whether or not to expand Medicaid in the coming months as they develop the 2014 budget, and already its causing lots of debate – as you would imagine.
The Senate has created a Select Committee on Patient Protection and Affordable Care Act (PPACA) and is inviting Floridians’ input on what Florida should do. They’ve even set up a webpage where you can submit your comments. Here’s what I submitted today:
As a Florida taxpayer and voter, I urge you to fully adopt the Medicaid Expansion limits set by the PPACA so that Florida will receive its share of the Federal funding (100% of the cost of expansion in the first three years, and 90% thereafter) toward the insurance of our uninsured. It’s the right thing to do.
It doesn’t have to be long or elegant. Just visit the webpage and tell them why you believe Florida should expand Medicaid coverage under the Affordable Care Act.
Let your voice be heard.