May 5, 2020

Top 5 Reasons Why Florida Needs to Expand Medicaid Now

Thirty-seven states have opted to strengthen their Medicaid programs by extending coverage to all adults with income under 138 percent of the federal poverty level.

Below, Florida Policy Institute counts down the top five reasons why state lawmakers must immediately expand Medicaid.

1. Building on Florida's Medicaid program is the most efficient and economical way to extend coverage to more than 800,000 uninsured Floridians with low income.

If the state expanded Medicaid to cover adults aged 19 to 64 with income up to 138 percent of the federal poverty level, more than 800,000 Floridians would gain access to coverage, including 400,000 residents stuck in the health care “coverage gap.” 

People need comprehensive health coverage that lets them access the care they need without worrying about whether they can afford it. Medicaid provides a full range of services, and the program’s infrastructure is already in place to provide coverage for COVID-19 testing and treatment.

The state could also take steps to make it easier for people to apply for Medicaid and stay covered, including simplifying the application, accepting self-attestation of information on the application, and getting more people enrolled quickly through “presumptive eligibility.”

2. Medicaid expansion would provide significant relief for Florida's state budget and a boost to its economy.  

Medicaid expansion would bring $14.3 billion in new federal dollars to Florida over a five-year period. These new dollars would help offset other state costs, including behavioral health services and health care for people involved in the criminal justice system. Florida could save nearly $200 million in state dollars annually. This additional funding would be one of the most rapid, proven-effective ways to deliver fiscal relief to Florida's economy during the forthcoming recession.

3. Floridians faced multiple challenges accessing affordable, quality health care before the pandemic. The COVID-19 health crisis and economic downturn have added countless new barriers.

Even before the pandemic, 2.7 million Floridians were uninsured, and that number will increase as unemployment rises. The state has a large share of seniors and people with disabilities — groups who are at the greatest risk of serious illness if infected by the virus.  

Florida's public health infrastructure, intended to be the first line of defense during a pandemic, has suffered from deep budget cuts.  Over the past decade, there has been a 10 percent reduction in county health department funding and a 3,500 reduction in staff.

4. People covered by Medicaid are more likely to have a consistent source of care compared to those who are uninsured.

Medicaid expansion would help divert demand away from already-stretched safety net providers trying to serve a growing number of uninsured residents during this public health emergency. The uncompensated care burden on hospitals already exceeded $2.5 billion annually before the COVID-19 crisis.

5. Federal relief packages do not include policies to expand access to coverage and keep the uninsured rate from rising during the crisis.

The Families First Coronavirus Response Act creates a new optional Medicaid coverage group for the uninsured, but it solely covers COVID-19 testing. It does not cover treatment. Moreover, Florida has not opted to include this group in its Medicaid program, despite that it would be 100 percent federally funded. The federal government's plan to cover provider costs for treatment of uninsured people with COVID-19 using a portion of the $100 billion in funding under the CARES Act is no substitute for comprehensive coverage. It does not provide coverage before, during, and after they are ill.

For more information, see the Florida Policy Institute policy brief, "Uninsured During the COVID-19 Pandemic: The Urgent Need to Build on Florida's Medicaid Program."

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