It’s time for the legislature to take action on Medicaid dollars

Grant Miller, Publisher

Grant Miller, Publisher

The world of political blogs and texting and the sort have made for many errors and confusion and retractions and corrections, but — zoweeeeeee! — what is in the water in Tallahassee?

Holy cow! First they announce that Washington has called off all discussions with Florida over the low income pool money with Secretary Liz Dudek and the agency for Health Care Administration, saying it probably signals the end to the possibility that there will even be LIP dollars. Then Washington authorities say, wait, the lead negotiator is going on vacation and will be back in two weeks; we’re only halting negotiations during his absence. Huh? One individual in Washington is the only person who can make a deal with Florida for the $2 billion in tax money that we’re negotiating for and he goes on vacation at the same time as the mid-session point for Florida’s constitutionally mandated 60-day session? Oh, ok, we get that!

Then just this week, Gov. Rick Scott says he is reversing his position and he no longer supports the expansion of Medicaid. That would be the $52 billion dollars in tax money sitting in Washington, D.C. that we are leaving on the table. Yep, BILLIONS! But, of course, this is the same Rick Scott who, shortly after he was elected to his first term, pulled the plug on the Bullet Train and said no to $2.5 billion. But in 20l3 he thought expanding Medicaid was a good idea.  Oh, okay, we get this, too. And he says we shouldn’t expand Medicaid because the federal government might pull the plug on their financial commitment just like they are doing on LIP. Talk about LIP disservice!

The end of the low income pool dollars, which, by the way, could mean as much as $500 million to Jackson Memorial Hospital, was specifically written into the Affordable Health Care Act, now five years old.  They didn’t imagine the Supreme Court would make Medicaid expansion optional, so they said within five years we wouldn’t need LIP money because all of the uninsured it is paying for today would be insured and covered by Medicaid. Yep, that’s where the $52 billion comes in over 10 years.

Last year, they also gave us an extension of one year at the last minute until mid-20l5, so it’s easy to understand how Gov. Scott is surprised by the end of the LIP funding in it’s current form. He, like so many others, probably never read the Affordable Health Care Act and the extension in 2014, days before the end of last year’s session and it may have been missed during the frenzy to further cut taxes.

But this is not the immediate problem. Would the Governor veto Medicaid expansion or LIP money if it was sent to him by the legislature? Hard to imagine, but stranger things have happened in Tallawhackee.

Well, it’s all attributable to partisan bickering. Oh, wait! The senate is in Republican control, the House has a super Republican majority and the Governor is Republican. Guess that doesn’t fit the definition of partisan bickering does it. With 39 Democrats left in the House it’s difficult to blame them for anything short of naming too many roads or passing too many resolutions and tributes. When it comes to substantive, policy the Republicans have no one to blame but themselves.

So what’s the hang up? Why won’t the legislature at least accept the money that we’ve sent to DC and they are offering to return for Medicaid expansion, the $2 billion in LIP money? Well, the senate actually says they will. They have a plan that is responsible and responsive and their budget, recently passed, actually includes the money from Medicaid expansion and LIP dollars. This has put the senate a mere $5 billion out of sync with the house budget, which means today either an extended session or a special session over the long hot summer. But, it’s not an election year, so all that will interrupt doing the people’s business are some vacation plans.

The senate has shown incredible leadership. Our own Sen. Rene Garcia (R-Hialeah) has been at the forefront of this issue and is being bombarded in his district by American’s for Prosperity — the Koch Brothers — that doesn’t believe we should take a single dollar from the federal government. Tell that to the 800,000 uninsured we have in Florida who would like to get into Medicaid managed care plans. As Sen. Don Gaetz said, tell my colleagues in the house that NO is not the answer to the health care needs of Florida.  Sen. Garcia should be praised and honored for the position he has taken.

And wasn’t that Rep. Jeanette Nunez on the floor of the house criticizing “the back row” — that’s where those 39 Democrats sit — for their position on the budget and on Medicaid expansion and LIP. Guess she feels secure in her position with Jackson Memorial Hospital where she is paid with our tax dollars. Notwithstanding the facts that the house position hurts JMH more than any other facility in Florida.

And how sad that the house members from Hialeah, including some future house leaders, don’t recognize that today their own community has the highest rate of uninsured and the highest rate of participants in the subsidies for so called Obamacare; not in Florida, in the nation! What ever happened to reflecting the voice of the people who sent you to Tallahassee?

It’s time for the voters of Miami-Dade to wake up and tell the house Republicans they can’t play politics with the lives of 800,000 people. They can’t tell people that the answer to providing health care to them is NO, not when the dollars are available and just waiting for them to act and accept the reasonable plan they are advancing that Sen. Garcia, Sen. Anitere Flores and Sen. Miguel Diaz de la Portilla have voted for, along with Sen. Gwen Margolis, Dwight Bullard and Oscar Braynon.

It’s reflective of the current status in Tallahassee that the senate budget passed unanimously off the floor with Democrats and Republicans saying YES. But what they are really doing is yelling down the hall to their colleagues in the House and urging them to listen to the voice of reason and good public policy. It’s no wonder that in one month the legislature has passed exactly l4 bills and the governor has signed only five of them. One set the presidential primary date, the other four are reviser bills, described as legislation to clean up language in existing laws.

Wake up and smell the Bustello house members! Do the right thing and take the senate plan or — here’s a novel concept — come up with your own plan that will cover 800,000 people and accept the money from Washington.

With all the positive momentum from business and bi-partisan political leaders, hospitals will have to continue to shift the cost of treating the uninsured to the insured, and healthcare costs will only increase and put some hospitals at risk of closing. Maybe that doesn’t concern JMH vice president Rep. Nunez, but it does concern us at Miami’s Community Newspapers.

The clock is ticking; do the right thing!

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