Thirty-six states and the District of Columbia have now expanded Medicaid under the Affordable Care Act, taking advantage of federal funding to improve the health of their populations and economies.

Florida remains among the states that have refused to do so, hurting more than 700,000 uninsured residents who would otherwise qualify for coverage. Unless state lawmakers act on Medicaid expansion in the next legislative session, Floridians should follow the lead of voters in other Republican-led states and look to the ballot box to make it happen.

New Florida Senate President Bill Galvano, R-Bradenton, has expressed an openness to using federal Medicaid funding to subsidize coverage for the poor. Galvano urged fellow Republican and incoming governor Ron DeSantis to use his relationship with President Donald Trump to help Florida land a Medicaid block grant to expand coverage.

“I think it is a positive that Governor-elect DeSantis has that relationship with the administration because that does provide some opportunity,” Galvano told Politico Florida.

Galvano said he wanted to proceed with caution to avoid a repeat of 2015, when the state Senate voted to expand Medicaid only to have the state House reject the plan. While that makes political sense, there are drawbacks to the block grant idea that simply expanding Medicaid would help avoid.

This federal government’s recent approval of a Medicaid change for Florida shows the opportunity and drawbacks in such an approach. The change lets the state only pick up 30 days of existing health care bills for those who become eligible who Medicaid rather than the 90 days that had been required, saving the state money but hurting poor, disabled and elderly people who would otherwise qualify for the longer period.

Florida currently ranks 42nd among states in its uninsured rate, with its number of uninsured children rising at a faster rate than states that expanded Medicaid. The number of uninsured children in Florida grew to about 325,000 in 2017 from 288,000 in 2016, bringing the state’s rate of uninsured children to 7.3 percent, according to recent report from the Georgetown University Center for Children and Families.

The study’s lead author told the News Service of Florida that the best thing a state can do to address such an increase is expanding Medicaid. Yet as the story noted, that is unlikely to happen in Florida due to the election of DeSantis, a strong opponent of the Affordable Care Act during his time in Congress.

Other Republican-led states have used ballot initiatives to expand Medicaid. Last month’s elections saw the passage of such initiatives in Idaho, Nebraska and Utah, with backers of the initiatives putting Florida on a shortlist of states where they might try next.

DeSantis and state lawmakers should consider whether they want to be constrained by such a measure or expand coverage on their own. The legislative session starting in March will be their opportunity to show they can get the job done or whether voters need to take the matter into their own hands with a ballot initiative.

 

This editorial originally appeared in the Gainesvile Sun.