Today, U.S. Reps. Kathy Castor (FL14) and Ted Deutch (FL22) led the entire Florida Democratic Congressional delegation in a letter to Florida Governor Ron DeSantis encouraging him to reject proposals to undermine Florida’s Medicaid program and instead to expand Medicaid to benefit countless Floridians and Florida’s economy.
The letter is signed by Reps. Castor (FL14), Deutch (FL22), Hastings (FL20), Wasserman Schultz (FL23), Wilson (FL24), Frankel (FL21), Crist (FL13), Demings (FL10), Lawson (FL05), Murphy (FL07), Soto (FL09), Mucarsel-Powell (FL26), and Shalala (FL27).
"Instead of building additional barriers to health coverage for Floridians, we urge you to work with us to defend the vital consumer protections included in the Affordable Care Act and to expand Medicaid to serve Florida families and create a more efficient system of care in Florida" and “bring billions of our tax dollars home to Florida,” the Members write in their letter.
Read the letter here. The text of the letter is included below.
Dear Governor DeSantis:
Congratulations on your swearing in as governor of the great State of Florida. We look forward to working with you to improve the lives of all Floridians. Affordable health care is fundamental to the wellbeing of the families we represent and we encourage you to shift the state’s focus to constructive improvements in care and coverage and build on the success of the Affordable Care Act, Medicaid and Medicare.
The success of the Affordable Care Act in Florida is clear as demonstrated by the historic number of Floridians who found affordable health coverage through the Affordable Care Act (ACA) marketplace for 2019 – approximately 1.8 million Floridians. Florida again led the nation in the number of citizens who enrolled. Affordable health coverage will bring economic security and peace of mind to many of our neighbors. Even in the midst of concerted efforts by the Trump Administration and Republicans at every level of government to sabotage the ACA, the citizens of Florida have spoken on the importance of affordable health coverage through the robust enrollment numbers.
Affordable coverage for Florida families is at risk, however, due to a misguided federal lawsuit making its way through the courts. We encourage you and Attorney General Ashley Moody to remove the State of Florida from the federal lawsuit that would kill the ACA and rip health coverage away from American families, including individuals with preexisting health conditions. Former Governor Rick Scott and Attorney General Pam Bondi never should have joined the lawsuit to destroy the ACA. Following the federal court ruling last month, it is more imperative than ever for the State to withdraw and instead side with the almost eight million Floridians with preexisting conditions – including the 2.1 million Floridians with preexisting conditions who have individual coverage. We urge you to stand up for Florida families and vital ACA consumer protections that save lives and save money. As we asked Governor Scott in June 2018, we urge you to withdraw from this dangerous lawsuit and work with us to adopt consumer protections that will protect Florida families – especially those with preexisting conditions.
The ACA, Medicaid, Medicare and private health policies work in tandem to keep Floridians healthy and well. Misguided changes to our insurance framework spell trouble for Florida. For example, recent comments regarding “Medicaid block grants” as a potential way to control costs for health services for Florida families caught our attention because block grants would cause massive losses of revenue to the State and trigger huge cuts in care. A Medicaid block grant would put the health of our most vulnerable neighbors and our state’s budget in jeopardy. Instead, we encourage you to work with us to expand Medicaid and to encourage Floridians to enroll in comprehensive coverage. The key to reducing health care costs in Florida is to ensure that Floridians have affordable and meaningful “coverage” and to end the costly and inefficient system that exists now.
Block granting Medicaid or considering per capita caps would be uniquely devastating to Florida. In Fiscal Year 2017, the federal government funded 61.2 percent of the $23 billion Medicaid budget in Florida. A block grant would place an arbitrary cap on that federal Medicaid percentage (“FMAP”) and slash billions of federal dollars sent to Florida. At the same time, the needs and population of the state will grow. Federal Medicaid matching dollars must grow or else the state will be on the hook for enormous costs or will have to institute devastating cuts in care.
Florida is more susceptible to economic swings and natural disasters than the rest of the country. Fortunately, the FMAP increases when Florida experiences an economic downturn, health crisis or hurricane, but would not increase under a block grant. Our state cannot afford to suffer under arbitrary “caps” in assistance especially during a crisis. In recent years, hurricane damage to Puerto Rico brought tens of thousands of new Floridians to our state, a Zika outbreak in 2016 put pregnant women at risk, and the opioid crisis continues to grow in our communities. A block grant would put our Medicaid budget at risk and trigger cuts in basic care, cuts to already underpaid providers, and cuts to other important state responsibilities like education and infrastructure.
At present, Medicaid in Florida covers mainly children, seniors in nursing homes and pregnant women - our most vulnerable neighbors. Capping federal resources devoted to their care is inconsistent with our values and unwise due to the major financial burden that would be shifted to the state and local communities. Provider payment rates also would suffer in a state that already underpays many doctors and medical professionals.
Instead of a devastating block grant approach, we urge you to expand Medicaid to bring billions of our tax dollars home to Florida and create a more efficient health care system. Medicaid expansion would ensure that our neighbors get the care they need and would boost our economy. Thirty-six states and the District of Columbia already have expanded Medicaid to provide affordable health care to working families and students. This includes several states led by conservative governors who have found a way to make Medicaid expansion work for their states. Florida’s failure to expand Medicaid to date has cost our state $66 billion according to an analysis by the Robert Wood Johnson Foundation and the Urban Institute. Recently announced appointments have us concerned with the direction your administration may take, so we strongly urge you not to leave Florida’s hard-earned tax dollars in Washington even one more day and expand Medicaid immediately. Otherwise, Florida remains at a significant financial disadvantage compared to the states that acted to expand Medicaid.
Medicaid expansion also is the right thing to do for the health of Floridians. Earlier this year, The Urban Institute estimated that Florida’s 15.7 percent uninsured rate would drop 4.5 percent if we fully implemented expansion. In addition to sharp reductions in the uninsured population, “expansion greatly improved access to care, generally improved quality of care, and to a lesser degree, positively affected people’s health.” Providing hardworking Floridians access to comprehensive health coverage would provide a path toward improving preventive care, management of chronic conditions, diverting routine health care out of hospital emergency departments, and reducing uncompensated care.
Medicaid expansion also is the right thing to do for Florida’s budget and economy. Medicaid expansion will boost jobs and enable Florida to move to a more efficient health care delivery model. Earlier estimates suggested that the state would have seen $8.9 billion in increased economic activity and 71,300 new jobs in 2016. These economic benefits would start in the health care sector and then spread throughout other parts of our economy. Additional costs associated with expansion are estimated to be either fully or largely offset by savings from other programs. Furthermore, no studies have shown that expansion would negatively impact job creation, employee behavior, labor force participation, or the number of work hours per week. A healthy workforce makes for a healthy economy.
Finally, Medicaid expansion is popular. A survey published by the University of Maryland’s Program for Public Consultation found that 67 percent of Floridians support moving forward with expansion to bring $66 billion in federal funding between 2013-2022 to our state. This fall, residents of three red states, Idaho, Nebraska, and Utah all voted to expand Medicaid coverage. That followed a successful 2017 Medicaid expansion referendum in Maine.
Instead of building additional barriers to health coverage for Floridians, we urge you to work with us to defend the vital consumer protections included in the Affordable Care Act and to expand Medicaid to serve Florida families and create a more efficient system of care in Florida. Medicaid expansion would aid the state’s bottom line as well. A Medicaid block grant would prove devastating to the State of Florida and should be taken off the table immediately. Instead, we urge you to focus on coverage for Floridians and eliminating costly emergency room visits and delayed care.
In your inaugural remarks, you stated that, “[i]n no area is legislative initiative more needed than in the field of health care. The escalating cost of medical care, prescription drugs and health insurance has wreaked havoc on family budgets, priced many out of the market entirely, and has put significant stress on our state budget. ... The people of Florida deserve relief.” We agree and urge you to take concrete steps to improve affordable, quality health care to our neighbors across Florida. We look forward to working with you on behalf of all Floridians and to the betterment of the state we love. Thank you.
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