Amid accusations of foot-dragging on the implementation of Obamacare by Democratic legislators and other liberal interest groups, the Republican leaders of both chambers of the Florida Legislature on Wednesday laid blame for the delay squarely on the shoulders of the Obama administration itself.
Weve had lots of dialogue with [the federal government], but theyve given us a clear indication that its all-or-nothing with Medicaid expansion, and thats unfortunate, Senate President Don Gaetz, R-Niceville, told reporters at the Associated Press annual editors meeting, in response to a question from Sunshine State News.
What if we had enough money to do some, but not all? What if we felt we could take a risk with some, but not [with] everybody? In every other kind of health benefit that we do, we draw distinctions as to whos eligible and whos not. Unfortunately, in [Obamacare] that distinction is not made in terms of the issue of expanding Medicaid.
Gaetz was referring to the controversial 2010 health care laws provisions allowing states to expand Medicaid coverage to all citizens with income below 138 percent of the poverty line. As of now, only certain classes of needy persons are covered by the program --e.g., pregnant women, children, needy families, the blind, the elderly, and the disabled.
Gaetz joined House Speaker Will Weatherford, R-Wesley Chapel, to announce theirfive-point Work Plan Florida to the assembled reporters and editors,but after their joint conference answered several questions about the states implementation, or lack thereof, of the Patient Protection and Affordable Care Act (Obamacare).
There were a lot of hopes that [the federal government] would allow us some flexibility, that we could expand in one area but not another, but they basically said you have to expand for all populations up to this level or you cant do any of it, Weatherford told the audience. Thats put all legislators, all governors, and al state governments in a pretty tight box.
Both Gaetz and Weatherford insisted they were in no rush to decide whether to expand Medicaid or to decide whether Florida will be operating its own health-insurance exchanges or leave them for the feds to run.
Were going to measure twice and cut once, Gaetz said. Sometimes its good to be the second one in the mine field. We think theres a lot to learn from watching how other states proceed. Theres no reason that we have to make a decision before we have to make a decision.
The federal government will be picking up the tab for running Floridas health insurance exchanges, at least for the time being, since the state declined to meet a December 2012 deadline. Nothing precludes the state from eventually taking that over, should the Legislature approve it.
In addition to chiding the Obama administration for its inflexibility vis-a-vis Medicaid, Weatherford suggested that Washingtons fiscal irresponsibility and unpredictability is also to blame for Tallahassees reticence to move forward.
If you were to talk about a federal government that had a balanced budget, a federal government that was not arguing over the debt ceiling every three to six months, if we had absolute certainty that they could fund this $60 billion operation just in Florida, not [to mention] the other states, I think thered be a different conversation, he told the audience. If you allow for the Medicaid expansion and add [over] 1 million ... people onto the Medicaid rolls, and four or five years down the road the fed government says Oops, we cant afford to pay this anymore, its now your job, [where will we find] the $8-10 billion to fund it?
Both legislators went to great lengths to emphasize their commitment to the maintenance of a welfare safety net, but Gaetz said Obamacare doesnt permit them to distinguish, in the words of British Prime Minister David Cameron, between those who choose to sit on the couch and those who cant get off the couch to go find a job.
Since we have limited money, wouldnt it be good to provide care and health first to those who need it the most, as opposed to those who arguably would need it less than others? Gaetz asked.
Later at the meeting, House minority leader Perry Thurston, D-Fort Lauderdale, blasted Republicans for what he called their foot-dragging on implementing the federal health care law
Were going to save lives. Were not talking about turning down money for a rail system; were talking about saving lives, Thurston told reporters. Not to do this would be morally reprehensible.
Reach Eric Giunta at egiunta@sunshinestatenews or at (954) 235-9116.