Mitch Perry Report 4.17.14: The latest Democratic plan to save Medicaid expansion


It's a dream that refuses to die, and its supporters maintain, it never should.

I'm referring to the idea of having Florida accept the Obama administration's plan to expand Medicaid enrollment, which would add close to a million people to the insurance rolls.

The latest gambit comes via Florida Democratic Senator Bill Nelson. As the Tampa Bay Times' Tia Mitchell reports today, the Sunshine State's senior senator wants to use health care funds raised by the state's individual counties to pick up the 10 percent slack required from the state after the first three years of the program (which comes without any cost to Tallahassee).

"If you really want to get it done, and if your reason for opposing it really was that you didn't want to commit state tax dollars in the out years to expanding Medicaid, then this is the opportunity to do that," Nelson told the Times. As Mitchell reports:
His plan would require the 32 counties that boost their hospitals' Medicaid funding with local dollars to instead use $3.5 billion of that money to cover the state's part of the expansion for 10 years. All 67 Florida counties would benefit, even if they didn't contribute.
Would the counties all agree to this? Nelson says local officials he's spoken with support the proposal. But any such plan would still require approval from the GOP-led Legislature, and the majority of their members — particularly in the House — are vehemently against the idea.

It's certainly a creative way of getting out of most GOP legislators' complaints that Medicaid is a broken service and doesn't need to be enhanced since it's already flawed. That's pretty much the stance of state Republicans I've spoken with. Add to that the strong ideological revulsion emanating from Will Weatherford and Don Gaetz, and you have any type of hybrid-plan on Medicaid expansion pretty much dead on arrival, regardless of its merits.

And yes, it's good politics by Nelson to bring up an idea which he probably suspects isn't going anywhere, because it keeps the issue alive. Look, Weatherford and friends are in direct conflict with their usual allies like the Chamber of Commerce on this one, their intransigence having been locked in from the get-go. And it certainly can't be forgotten that Rick Scott has done little to support Medicaid expansion, even though he said at one time that he supported it.

A Gallup poll released yesterday showed that states that have expanded Medicaid and opened their own exchanges have seen a higher rate of decline in the number of uninsured, compared to other states. The 21 states and the District of Columbia, which have done both, saw an average decline in uninsured of 2.5 percent, according to the poll. The other 29 states that didn’t enact both measures had a dip in uninsured of less than 1 percent on average. 

Moving on.....St. Pete Mayor Rick Kriseman was joined by the mayor of Gulfport and 50 gun-control advocates yesterday on the steps of St. Petersburg's City Hall, where they came together to champion a new campaign to get a million more folks who support gun control legislation to join their organization.

The Reverend Dr. Manuel Sykes says he's going to decide very soon whether or not to jump into the CD13 Democratic primary....

And Tampa Democratic Congresswoman Kathy Castor says she has no hope in the next few years that House Republicans will see the light and support the comprehensive immigration bill passed by the Senate in 2013.

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