The Florida House has started laying out its case to opposition for the Senate’s Medicaid expansion plan.

The Senate wants to use federal Medicaid expansion dollars from the Affordable Care Act to help uninsured Floridians purchase private health plans. But the house has long been opposed to the plan. House Speaker Steve Crisfaulli says even the Senate’s willingness to drop part of its proposal which enrolls more people into the state’s current Medicaid Managed Care system isn’t enough to sway him.

“It's still Medicaid expansion. It uses the Medicaid population It uses the Medicaid expansion dollars, and the program rules. It’s Medicaid expansion. There’s a saying, if it walks like a duck, quacks like a duck, it’s a duck.”

Florida House members met Monday during a committee hearing on the Senate plan, and Republicans quickly zeroed in on parts of the proposal they find objectionable. One contentious issue is how many people would qualify.  Republican Representative Travis Cummings thinks the number is about half the 800,000  figure widely reported, and state economist Amy Baker says that’s true. Some people may already have insurance and others could fall out of the system as its implemented.

“Roughly half of the population is removed trough the restraints or secondarily from that attrition rate—they’d have an issue paying the premium, completing the paperwork or having the information to complete the paperwork," she said.

Republican Representative Cary Pigman is concerned about the eventual phase-out of the state’s Medically needy program. It provides monthly financial assistance to Floridians people with critical illness who are uninsured.

“Since the medically needy program has always been our safety net, for the most seriously ill, most seriously injured, then we have the potential for 58-hundred people with the greatest need losing coverage, in order to insure a large number of able-bodied, well individuals," Pigman said. 

The Senate’s plan would save the state money in the future, but there are concerns its work requirements, premiums and co-pay provisions may not be approved by the federal government. The Senate’s health committee reaffirmed its support for Medicaid expansion in a vote Monday. And Senate President Andy Gardiner says if his chamber’s plan does fail, the issue won’t go away.

“I think this is the future. Whether you like Obamacare or not, it has changed the dynamics of the way healthcare is delivered in this country. Whether you like it or not.”

The legislature has reconvened to iron out a budget for the upcoming fiscal year address to a myriad of health-care related proposals, and figure out how to plug a billion-dollar budget hole caused by the phasing out of a critical hospital reimbursement program.

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