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Health reform succeeding in spite of itself

Medicaid rolls grow as Florida Republicans privately consider accepting federal cash for expansion

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An unexpected and underreported side effect or the recent (and troubled) launch of the Affordable Care Act – and every sob story the noise machine can pull up for broadcast hate parades – has been that the rollout may be doing substantial good for the country’s most needy in spite of itself. How’s that, you say? Well, you’ll recall that in sane states, accompanying the ACA was the federal funding to those willing to expand their Medicaid programs to include those earning up to 133 percent of the federal poverty level (about $15,000 a year). So, in those states that have been cooperating with the expansion (and even in those without, just by principle), the outreach programs from all of the ACA hype have identified and enrolled nearly 400,000 people into Medicaid, four times the number enrolled in the exchanges so far, according to WUSF News.

“At any given time, only two out of three people who are eligible for Medicaid are enrolled,” Michael Cannon of the libertarian Cato Institute told WUSF. “And so if you have this big expansion with this big media education campaign, a lot of those people who are already eligible will go and enroll in the program.”

All of this, of course, comes with a caveat, especially for states like Florida that refuse to expand their Medicaid programs to properly accommodate expanding rosters. Which may go some way in explaining why the Guardian published a story on Nov. 21 headlined, not at all salaciously, “Florida in secret talks to accept funding for Medicaid from Affordable Care Act.” Say what? Well, it’s actually a repeat of what the state Senate tried to do last legislative session: call a donkey an elephant. If the state legislature can come up with an alternative means of accepting the cash – which hospitals desperately want them to, and hospitals are really big donors for Republicans – then they can still get the money without admitting defeat.

“We believe strongly that we ought to be taking that funding,” Florida Blue chief executive Patrick Geraghty told the Guardian, adding that he thinks the state will “do the right thing” and come up with a logical alternative that could assist a health care system that could be in crisis from all of this limbo. The Florida Democratic Party seemed caught off guard by the Guardian piece on Thursday, with Florida House Democratic Leader Perry Thurston issuing the following statement:

“Aside from today’s news report, I am not aware of new conversations between healthcare stakeholders and legislative leaders about Florida accepting available federal dollars to provide affordable, quality health coverage to Floridians. However, I am hopeful that Republican legislative leaders and Governor Rick Scott will recognize the profound need, and will take positive bipartisan action, to reduce the high number of uninsured Floridians.”

Hope for change, then.

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