PEMBROKE PARK, Fla. – With Obamacare, Florida is slated to receive some $51 billion in federal money over the next ten years to help bring health insurance to those who aren't covered now.
It's a windfall that is not only expected to cover more than 1 million people, but also bring jobs and provide a shot in the arm to the economy.
But the Republican-dominated Florida House voted Thursday to reject that money based on members' ideological opposition to Obamacare and the notion that at the end of the decade the state will have to pay. They voted instead for a plan footed solely by Florida taxpayers that would help only a fraction of people that would benefit under the federal plan.
Democrats and a couple of moderate Republicans urged the House to vote for a Senate compromise that puts the billions in federal money not toward expanding Medicaid as originally intended under the president's plan but to provide private insurance to about one million currently uninsured Floridians. But the Democrats' bid went down in a 71 to 45 vote to reject the federal funds.
"What business person doesn't take this deal?" asked Joe Gibbons, a Democrat from Pembroke Park. "… [The Republican opposition] is about ideology, not people … our economy needs this, we need this."
"The war on Obamacare is really what this comes down to," said Rep. Javier Jose Rodriguez (D-Miami). "The casualties of that war are the 1.1 million uninsured [that the Senate version would help]."
The leader of the House effort is Speaker Will Weatherford, who drew a line in the sand on the issue at the recent heavily partisan Conservative Political Action Conference. In a speech at the conference, he said he's fighting a "real battle for the Republic" in Tallahassee and that states are being "coerced into expanding Medicaid."
"We're showing the federal government you don't have to spend money you don't have," said Weatherford. "… They're trying to buy us off one by one but I am not buying it and Florida isn't buying it."
Weatherford said he was building a "pocket of freedom" in Florida, what he called an "Atlantis."
Following his lead, House Republicans held their ground on the issue, claiming the federal government is giving away money to states that it doesn't really have and that people should work hard enough to make enough money to afford their own private health insurance rather than taking the federal tax money.
"The fallacy is the representation that reliance on government is somehow better than a job that leads to self-determination," said Rep. Matt Gaetz (R-Fort Walton Beach) on the House floor before the vote. "And it is truly a fallacy if you believe that you can sell to Floridians that they are better off if they are able-bodied and at home playing Grand Theft Auto rather than having a job and contributing to the things that we care about."
The brunt of the state's uninsured "are not going to be offered anything other than our free clinics" and "will be encouraged to get a job," said Rep. Travis Cummings (R-Orange Park).
But Steven Ullmann, University of Miami's director of health sector management and policy, said the fallacy is that a majority of people who don't have health insurance don't have jobs. In fact, said Ullmann, the great majority of those without health insurance do have jobs. He pointed out that there are about 700,000 people on Florida's unemployment rolls, while there are about 4 million people without health insurance.
"These are people that are working at manicurists, people working at the retail stores, people out there repairing cars, this is Florida and this is very much a part of our economy," said Ullmann. "These are the individuals who are working hard trying to support a family but lack the income and lack the access to get health insurance."
Several House Republicans said that those who don't have health insurance can receive care at public clinics and emergency rooms. But Ullmann said that is no solution because it makes it more expensive for everyone and ultimately it is the insured – and taxpayers – who foot the bill.
"You ultimately do pay for the uninsured because you pay for it in terms of your premiums your deductibles and your co-payments," he said. "You are subsidizing those who cannot afford access to health care. … Your emergency room is one of your most expensive and it can be argued one of your lower quality providers because you have no continuity of care," he said.
Rep. Jimmie Smith (R-Inverness) said one reason he wants to reject that federal money is that he believes there aren't enough doctors to treat those people who would become insured through Obamacare. "A board stretched out, it can hold a lot of weight," he said."But if you drop a whole lot of weight in the middle at one time, that board breaks. We don't want to break this system by shocking it."
Gov. Rick Scott initially touted the idea of rejecting the money, but he now supports the Senate compromise. As the legislative session is scheduled to end on Friday, a special session could be called to hammer out a plan that wouldn't forfeit the billions in federal money.
Republican lawmakers in about 15 states, including Florida and Texas, are trying to reject the federal windfall while 35 states are readily accepting their share of the money.