For weeks, Florida's hospital industry has lobbied to expand the Medicaid program under the federal Affordable Care Act -- only to see state lawmakers balk.
But while not backing away Tuesday from the Medicaid expansion, industry officials said a new Senate proposal at least seeks to address their goal of making sure hundreds of thousands of uninsured Floridians receive health coverage.
"For us, getting people covered is the issue, and what you call it is really not that important,'' said Bruce Rueben, president of the Florida Hospital Association.
Tony Carvalho, president of the Safety Net Hospital Alliance of Florida, said questions remain about critical details of the Senate proposal to offer subsidized coverage through private insurers. That includes whether Washington would go along with the idea, which will depend on using federal money that otherwise would go toward the Medicaid expansion.
Carvalho described moving forward with the proposal as a "long haul" but, like Rueben, he said hospitals are concerned about making coverage available.
"We want the uninsured Floridians to have access to health care,'' Carvalho said.
Rueben and Carvalho made the comments after a group known as "Florida Remedy," which is led by the Florida Hospital Association, held a news conference to press lawmakers to expand Medicaid coverage. The issue has high stakes for the hospital industry, which has long complained about being saddled with uncompensated care because of uninsured people showing up in emergency rooms for treatment.
Following the lead of House Republicans, a Senate select committee voted Monday to reject expanding Medicaid under the Affordable Care Act, better known as Obamacare. But select committee Chairman Joe Negron, R-Stuart, outlined an alternative that would build on an already-existing state program, Florida Healthy Kids Corp., and offer subsidized private health insurance.
Negron's concept would target the same group that a Medicaid expansion would cover -- those whose incomes are up to 138 percent of the federal poverty level. Also, it would rely on federal money, which is supposed to cover all of the Medicaid expansion costs from 2014 through 2016 and later pay 90 percent of the costs.
Negron said Tuesday that lawmakers have enough time to put together details of the plan and work with the federal government to get access to the money. He said his goal is to offer subsidized private insurance coverage, rather than enrolling uninsured people in Medicaid.
Florida's hospital industry has been a major supporter of the Medicaid expansion. Along with the longstanding problem of uncompensated care, hospitals also could lose hundreds of millions of dollars in the future because of cuts in what is known as the "disproportionate share" program.
That federally funded program provides money to help offset costs of uncompensated care. But with the Affordable Care Act based on the idea that fewer people will lack health insurance, disproportionate share payments are expected to be reduced in the coming years.
During Tuesday's news conference, hospital officials from Tallahassee, Tampa and Fort Myers said the state needs to move forward with the coverage expansion.
"Extending health care coverage to 1 million or more uninsured Floridians is the right thing to do,'' said Erin Ennis, a board member of Tallahassee Memorial HealthCare. "Extending coverage will be good for our economy, as well."
But Rep. Mike Fasano, a New Port Richey Republican who spoke during the news conference, had harsher words for lawmakers who are blocking the Medicaid expansion and pursuing a possible alternative.
"Ladies and gentlemen, that's a cop out,'' Fasano said. "It's nothing more than a cop out."
