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Senate committee rejects Medicaid expansion, joins House in seeking alternative

Instead of expanding Medicaid, Florida should create its own program that helps the uninsured buy private insurance policies, the Senate select committee on the Affordable Care Act decided today.

"I oppose the Washington plan, and I want a Florida plan," said Sen. Joe Negron, the Stuart Republican who chairs the committee.

The debate was very similar to what played out in the House one week ago. Once again, Republicans spoke against Medicaid and voted against expansion while the Democrats, who are in the minority, took the other point of view. The committee vote was 7-4 against Medicaid expansion.

Compared to the House, the Senate has expressed more of a willingness to find an alternative program that still would allow Florida to draw down billions of federal dollars currently intended for Medicaid. The House is pursuing alternatives, too, but said the loss of federal funding won't be a deciding factor.

Negron outlined five "guiding principles" he believes should be contained in the Senate's alternative:

  • -cost-sharing that required plan participates to pay something for emergency room visits and other services they used, based on income.
  • -Administering the program through Florida Healthy Kids, currently the state program that helps children ages 5-18 obtain coverage.
  • -Creating "health reimbursement accounts" that reward participants for healthy behavior by adding money to accounts that can be used for co-pays.
  • -Allowing participants to purchase private health insurance plans.
  • -Using available funds to help subsidize the premium costs of the insurance plans.

The only other member of the committee to float an alternative was Sen. Aaron Bean, R-Fernandina Beach. He said the state should build upon the existing Affordable Care Act provisions that provides subsidies for people to purchase health insurance via exchanges, but acklowedged he didn't have a clear plan for helping the roughly 600,000 Floridians who don't make enough to qualify.

Democratic members of the committee said they were willing to hear alternatives but urged colleagues to support expansion as a back up plan.

“There is coverage at least that we know about in a Medicaid expanded world," said Sen. Audrey Gibson, D-Jacksonville.