Medicaid Spending Trends Do NOT Justify Opposition to Its Expansion | Print |  E-mail
August 2012

Although the extension of the Medicaid safety net is now the law, some governors and others opposed to the Affordable Care Act have taken to describing it as optional.  Because it has become clear that Medicaid expansion would increase the state's share of Medicaid costs by a negligible amount, opponents have been forced to try to shift the focus.

In defending his intent to reject the opportunity to extend coverage to more than a million uninsured, low-income Floridians for pennies on the dollar, Governor Rick Scott has insisted that the burden of the current Medicaid program is already too onerous.   One particular claim used by the Governor is that "Medicaid [spending] has been growing three and a half times as fast as General Revenue."

In this brief, we examine the "statistic" behind this claim and explain how it is misleading and so inapplicable to current conditions that updating the underlying data used to derive it would yield a conclusion opposite to the one advanced by the Governor and others.

The net cost to the state of extending Medicaid coverage to more than a million of the lowest-income, uninsured Floridians would be little to nothing, particularly after factoring in reductions in the cost of the delivery of "uncompensated care" in settings such as hospital emergency rooms.

> Read the report.

Medicaid Expansion Would Reach Only Low-Income Floridians | Print |  E-mail
July 2012

In June, the U.S. Supreme Court June decision upheld the constitutionality of the Affordable Care Act (ACA) in full, but nevertheless held that states could not lose funding for their existing Medicaid programs if they rejected the ACA’s Medicaid expansion, which would extend coverage to more than a million of the lowest-income, uninsured Floridians. Since then, Florida Governor Rick Scott and other ACA opponents have argued that expansion is in fact unnecessary because the needs of low-income Floridians are already being met through Florida’s existing Medicaid program. The reality, however, is different.

> Read the report.

Rejecting Medicaid Expansion Not a Sensible Option for Florida | Print |  E-mail
July 2012

Although Florida's elected leaders may have the political option of rejecting Medicaid expansion under the Affordable Care Act, actually doing so would cause serious harm to the state and its economy.

Rejecting Medicaid expansion would cost Floridians $20 billion in unused federal dollars and tens of thousands of new jobs, while denying the lowest-income workers and families much-needed coverage.

> Read the report.

Florida Insurers Complying with Early ACA Provisions, But Future Benefit Threatened by State Inaction | Print |  E-mail
June 2012

Although a decision by the U.S. Supreme Court regarding the constitutionality of the Affordable Care Act is imminent, many provisions likely would remain in effect unless the court invalidates the entire ACA.

Contrary to the portrayal of the ACA by opponents as federally directed, state leaders and state agencies play the central role in configuring access to ACA benefits and protections.

Nevertheless, the law has been met with fierce and persistent opposition from Florida's elected and appointed leadership, and state-level efforts to implement the ACA have remained at a virtual standstill for more than a year and a half. This inaction and outright resistance raises a question of whether Floridians might face delayed or denied access to the intended benefits of the ACA's key reforms as they take effect during the next few years. On the more immediate front, it gives rise to questions about the extent to which Floridians have access to the limited but important ACA benefits that should already be available to them.

Despite the fact that Florida remains mired at "square one" in implementing the ACA, Florida insurers nevertheless appear to be generally compliant with the effective provisions of the ACA, and millions of Floridians are benefiting as a result.

These findings are cause for both confidence and concern among Florida consumers. While indications are that insurers have taken and will make some effort to comply with the law, the extent and level of compliance will be considerably lower and less continuous without strong transparency requirements and enforcement mechanisms by the state.

> Read the report.

Changes to Medically Needy Program Will Push Most Out of Coverage | Print |  E-mail
June 2012

The Medically Needy component of the Medicaid program provides short-term coverage to Floridians who are over income for regular Medicaid but have catastrophic medical expenses.

On April 26, the state requested federal permission to require, for the first time, that all Medically Needy participants enroll in a managed care plan and pay monthly premiums, purportedly to ensure their access to continuous coverage.  However, failure to pay those premiums, which could absorb up to 90 percent of a participant's household income, would end their eligibility for Medicaid altogether.

Virtually no Medically Needy participants would be able to afford the premiums, and the inevitable result would be loss of access to Medicaid and harm to hundreds of thousands of the most vulnerable Floridians.

> Read the report.

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