Most Floridians don’t understand why so many people in our state are uninsured, or why our health disparities are among the worst in the country, or what can be done.
Anyone who cares about these issues – and about improving health outcomes and reducing costs – should appreciate the extremely powerful role of the state legislature. It is a lesson in basic civic education. Equally important is understanding the story of what happened in the Legislature over the past eight years, as Florida has refused federal funding to cover uninsured residents.
Everyone should know the position of their state representative and senator on the expansion of Medicaid. But when lawmakers don’t even allow debate, recording the story can be difficult. The Miami Herald editorial from June 13, “Poor, uninsured? Republicans don’t care, ”provided essential historical facts. He quoted the Speaker of the Florida House of Representatives and Speaker of the Senate as explaining why, even while we were in the midst of a deadly pandemic, they would not allow Medicaid expansion to be considered during the session. from 2021.
A quick review: The Affordable Care Act requires states to cover uninsured low-income adults through Medicaid. While states pay 40-50% of the costs of the regular Medicaid program (with the federal government paying the remainder), states pay no more than 10% of the costs for this expanded coverage group. Tragically, in 2012, the Supreme Court ruled that the ACA’s Medicaid expansion provision must be a state “option” rather than a “requirement.” Florida is one of 12 states that chose not to cover our fellow Floridians. In short, funds dedicated to the insurance of our most vulnerable neighbors are languishing in Washington – readily available, but denied by the legislature.
There is a mountain of undisputed evidence that the expansion of Medicaid improves health outcomes, reduces disparities, improves family financial stability, boosts local economies, and results in state budget savings. As part of the recently adopted US bailout, the federal government came up with a deal that seemed too good to refuse. In return for the Medicaid expansion, Florida would receive additional federal dollars amounting to a net fiscal windfall of over $ 1.8 billion.
Yet Florida and a handful of other state legislatures have refused to extend Medicaid. On Thursday, however, the Missouri Supreme Court ruled unanimously in favor of implementing a voter-approved Medicaid expansion plan, which Republican lawmakers and the state governor attempted to push through. to block.
In light of the recent United States Supreme Court ruling re-confirming the ACA, it’s reasonable to predict that over time, every state will eventually expand Medicaid. As we wait, work, and hope for this to happen, the facts behind Florida’s shameful health justice and justice story will be recorded: How many tens of billions of dollars in our federal taxes? have been lost forever; how many millions of Floridians have suffered and died needlessly.
When will Floridians understand Tallahassee’s role in the state’s failure to expand Medicaid and hold state officials accountable for these incomprehensible losses?
As our grim bookkeeping continues, leaders in Congress are trying to end the horrific health injustice in Florida and other states with the recent Medicaid Saves Lives Act.
COVID-19 has made it clear that we cannot have racial justice without health justice, or health justice without racial justice. Notably, most of the non-expanding states are former slave states, and the majority of those harmed by our state’s withdrawal from expanding Medicaid are people of color.
Over 150 years ago, Congress passed the 13th Amendment to End Slavery. Hopefully Congress will once again save us from “our worst selves” by righting the unreasonable injustice of denying health care coverage to some of our most vulnerable and marginalized residents – as soon as possible.
Miriam Harmatz is Director of Advocacy and Founder of the Florida Health Justice Project.