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Legislators move closer to Medicaid expansion decision

Monday could be the day when House and Senate committees studying the health care law make a recommendation on whether the state should accept federal dollars to expand Medicaid. The committees will meet jointly in the morning then have separate meetings later that day, the last before the session officially begins.

To aide the decision-making, state analysts will provide updated estimates on the cost of expanding Medicaid and various other aspects of the Patient Protection and Affordable Care Act. Already today they released new numbers on the cost to the state for implementing the law for its own employees and Friday estimators will discuss the cost of Medicaid expansion.

Rep. Richard Corcoran, the Land O'Lakes Republican who is chairing the House committee, said the hope is that the committee is able to make a decision on Medicaid expansion and health exchanges Monday. The Senate committee has already recommended the state not pursue setting up an exchange for now.

As of today, Corcoran remains "skeptical" on the plan to allow 1 million people to join Medicaid. "There's clearly cost issues, you've seen that through the testimony," he said.

Indications are that the Senate is leaning toward embracing Medicaid expansion, something that Gov. Rick Scott said he also supports. The House is more conservative, and leaders have been vocal in criticizing this provision of the law.

If the Democratic caucus holds strong in the House, they would still need 17 Republicans to support Medicaid expansion to get a bill passed. So far only one, Rep. Mike Fasano, R-New Port Richey, has said publicly he will cross party lines.

House Minority Leader Perry Thurston said Democrats will try to make the case, but hospitals and voters are also going to be leaning on Republicans to support Medicaid expansion.

The House committee could eventually propose four bills, one dealing with a different aspect of the health care law: Medicaid expansion, health exchanges, insurance for temporary state employees who work full-time and updates to insurance regulations.

The revised figures out this morning on the impact the Affordable Care Act will have on the state's own health insurance program for employees update a report from December. It lowered the projected cost of offering full-time contract workers insurance to comply with the law. However, the estimated number of employees that will be affected by this change has increased.

The state now says there are 3,015 people working at state agencies in temporary positions who are averaging more than 30 hours a week. Another 5,722 people are working in the state university system to whom this applies.

That total, 8,737, is a 26 percent increase from the December estimate. The state also has 425 part-time workers that are earning enough hours to make them similarly eligible for benefits. (Right now these employees are offered insurance but pay a higher share of their premiums than full-time workers.)

In fiscal year 2014-2015, the first full year this provision of the law will be in place, implementing the Affordable Care Act for state employees is expected to cost the state $130.6 million. That is down from December's estimated $137.3 million. Those amounts will also be offset by the revenue received when employees pay a portion of premiums.

The House committee agrees that the state should offering full-time temporary employees health insurance to comply with the health care law. The alternative: a likely $321.8 million fine.