August 4, 2017

Federal Medicaid 'Per Capita Caps' Would Trigger Significant Cuts to Health Care Services for Low-Income Children, Women, Seniors and People with Disabilities and Shift Billions in Costs to Florida

This post was last updated on December 8, 2021. As new policies are announced, FPI will update this page.

As Florida’s response to COVID-19 takes front and center, concern grows for low-income families who struggle to take precautions against the spread of the virus. Although Congress has passed the Families First Coronavirus Response Act to address, at least in part,  the public health crisis and economic fallout from COVID-19, many barriers continue to keep struggling families from accessing the assistance they need during the pandemic. As Florida initiates policies implementing the Act and addressing other barriers to the safety net, FPI will update this form. When available, hyperlinks are provided to agency documents or statements that provide greater detail  about the new policy.

On March 22, 2020, FPI and 44 other organizations sent a letter to Governor DeSantis, leadership in the Legislature and agency heads to urge action on 47 specific policy changes to reduce unnecessary barriers for Florida’s safety net programs in response to the COVID-19 pandemic. See the letter here.

Critical federal funding that supports care for women, children, seniors and people with disabilities would be drastically reduced under proposed federal health care legislation. A confluence of unique state characteristics, such as the tremendous growth in populations of people with disabilities and the elderly, along with Florida’s already lean Medicaid program, would create particularly harsh consequences for the state. Outcomes would include more Floridians becoming uninsured, likely Medicaid service cuts, further restrictions on Medicaid eligibility and the loss of thousands of Florida jobs.

Federal efforts to repeal and replace the Affordable Care Act (ACA) have, so far, been unsuccessful. However, it is important to examine the implications of what has been at the core of multiple bills pushed by leadership in the U.S. Senate and House of Representatives —namely, the cutting and capping of Medicaid — as similar language is likely to emerge in future iterations of health care bills.

The Congressional Budget Office (CBO) estimated that Senate legislation, the Better Care Reconciliation Act (BCRA), would have caused more than 20 million additional Americans to be uninsured over the next decade and cut Medicaid by more than $700 billion over the same period. In Florida, the Urban Institute projected that by 2022, 1.5 million more Floridians would be uninsured and $8.2 billion in federal Medicaid funding to the state would be cut. Consequently, both the American Health Care Act (AHCA) passed by the House and the BCRA would have shifted billions in new costs to the state and created enormous hardship for Florida families, seniors and persons with disabilities .

While it is imperative that Congress act now to stabilize the private insurance marketplace, it must leave Medicaid intact. Proposals such as those contained in the AHCA and BCRA to cut and cap Medicaid funding would put the health of the most vulnerable Floridians at great risk.

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