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Medicaid Expansion Now in States' Hands

Margaret Dick Tocknell, for HealthLeaders Media, July 6, 2012

Officials at the Florida Hospital Association are now in the process of sorting out their options, Bruce Rueben, FHA president told HealthLeaders Media. "We want to see the coverage extended because that's the only way that the benefits of the law are going to be realized."

He noted that hospitals are contributing billions of dollars toward the coverage through cuts to hospital payments in Medicare and Medicaid. "We want to see people in Florida get the benefit of all that. Otherwise hospitals are simply going to have fewer resources to provide the same amount of uncompensated care that they have been providing."

Among the issues to be reviewed is how much power the Florida legislature will have to influence Gov. Scott's decision. "Nobody is going to change their mind before Nov. 6. Everyone is going to hold their position until we know the outcome of the elections. Then we'll sit down and begin to work with everybody."

For now, Reuben says the FHA will begin to build an economic and social case for extending Medicaid coverage. That means telling the story of Florida uninsured. According to the Urban Institute, about 1.6 million uninsured Floridian adults would be eligible for Medicaid if eligibility was expanded to 138% of the federal poverty level.

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3 comments on "Medicaid Expansion Now in States' Hands"


R Daniel King (7/11/2012 at 9:34 AM)
TennCare expanded Medicaid eligibility utilizing HMOs that grew into a financial crisis resulting in stricter eligibility. With no significant change in enrollment costs grew 3.5 times from $2.4 billion in 1994 to $8.5 billion in 2005. Why? Program never inspired health care efficiencies and quality. In 2003, Dirigo Health in Maine was a subsidized health care premium program that was suppose to insure 130,000 within five years. Today, less than 10,000 are under the program. Why? Never inspired health care efficiencies and quality. Hawaii employer mandated insurance started in 1974 and by 1992 all but 2% were insured. The Clinton Administration granted Hawaii "Medicaid expansion" to cover the 2% which failed after 9 years. The mandate is killing small business and Hawaii now limits its mandate to full-time employees causing an increase in part-time employees increasing the uninsured to 10%. Why? Never inspired health care efficiencies and quality. And just because someone has insurance does not mean they avoid bankruptcy since a 2007 study found 75% of bankruptcies due to health care bills had insurance! ObamaCare disciples will ignore the above failures and facts, but some governors have the courage to remember. Although ObamaCare feels good, it remains a dead program spending until the nation replaces it with a system the inspires ALL health care professionals to be in the constant pursuit of the most efficient delivery of quality universal integrated care. Meanwhile, ObamaCare will prove to be an economic coffin that many governors will rush to occupy.

Don Stumpp (7/9/2012 at 10:25 AM)
Agreed Christine! In my opinion, this is the heart of ACA - The expansion of insurance benefits to those who have no coverage. I just hope that the States who opt out do so because it is best for their citizens - NOT because they dont want to give a victory to Obama or Democrats. Put politics aside and tell me: how will your citizens be served by opting out? Let's go through it. The uninsured poor (133% FPL) either get care or they dont. If they get care, they dont pay for it, and the insured pay for it or the government thru DSH funds or other mechanisms. If they dont get care, they suffer or eventually get care when it then becomes more costly. The States need to think of Medicaid expansion not as same-ol' same-ol' FFS increases. If more people get HEALTH care we can reduce overall costs of SICK care. Let me ask - if your providers went to not extending credit to consumers and therefore one needed insurance or cash (Visa/mastercard/Discover accepted!), what would happen? If healthcare became like every other industry and expected payment at time of service, the lack of insurance would be painfully apparent. Walmart, Kroger or your local pizza place doesnt finance your purchase. Why should doctors? Even when you go to the pharmacy for your Rx - it is payment at time of service to the penny for any of 10,000 drugs on the NDC. Twitter: Iam4ACA

Christine Hankerson (7/6/2012 at 11:15 AM)
Why is there such resistance from the states? Either way the tax payers incur costs. So why not allow individuals to have healthcare under this Act, take the burden off the emergency departments, and ultimately hope for a healther country.