Trump administration will defray cost of Florida refusing Medicaid expansion

The Trump administration’s deal with Florida has implications for the rest of the country.

President Donald Trump waves as he walks across the south lawn of the White House in Washington late Saturday night, April 29, 2017, on this return from a rally in Harrisburg, Pa. CREDIT: AP/J. David Ake

A policy change by the Trump administration will effectively subsidize Florida’s decision not to expand Medicaid coverage under the Affordable Care Act, in a deal that could set a national precedent.

The federal government has made a deal with Florida to provide more money for state hospitals to treat uninsured people, which the previous administration would never have approved, according to The New York Times. The Obama administration argued that if Florida simply expanded Medicaid, fewer people would be uninsured, which means there would be less uncompensated care.

The “low-income pool” — meaning the pool of money set aside for uninsured, low-income people — will reportedly grow from $608 million per year under the Obama administration to $1.5 billion annually. Kansas, Tennessee, and Texas also have these low-income pools, and have also not expanded Medicaid.

Republican state lawmakers in Florida have fiercely opposed Medicaid expansion for the past four years, according to the Associated Press. Although the State House has proposed huge cuts to hospitals, at the time of the deal, Rep. Carlos Trujillo (R), the House budget chairman, said he would not promise the federal money would alleviate those cuts. Trujillo said the funds could allow lawmakers to focus on tax cuts or building up the state’s reserve accounts.

According to the Naples Daily News, the matter of how to handle the $1.5 billion has been left unresolved. Meanwhile, the state budget deal under negotiation would cut $651 million in Medicaid payments to hospitals.

This deal is the Trump administration’s latest action to sabotage the Affordable Care Act, commonly known as Obamacare. The president has also threatened Obamacare subsidies that would benefit low-income Americans; first, in order to get a deal on health care, and then to secure border wall funding in a spending bill. Neither of those threats achieved their ends.

On Sunday, Trump tweeted, “You can’t compare anything to ObamaCare because ObamaCare is dead.”

Although Democrats said they wanted a permanent commitment to funding the subsidies, the Trump administration did not give Democrats and insurers that certainty. Instead, the administration offered to fund the subsidies indefinitely, though Democrats said they don’t trust the president to stay true to his word.

A guarantee to make payments for five years, if Democrats can’t secure a permanent fix, would also address the concerns of insurers, who are grappling with the uncertainty caused by efforts to repeal Obamacare.

From day one, the Trump administration took steps to sabotage Obamacare by shortening the open enrollment period, doing less advertising and outreach, and weakening the individual mandate.

Health and Human Services Secretary Tom Price has continued to dodge questions about administering the ACA, and the department introduced a a website listing all of the actions the administration to undermine the ACA since Trump took office.

Some states have filing deadlines as early as this month for insurers to submit Qualified Health Plan applications to remain in the state insurance marketplaces. But when insurers met with the administration last month, it refused to make commitments on continuing the payments.

The Trump administration’s efforts to hobble Obamacare may backfire on it, however. According to a Kaiser Family Foundation poll released in April, 61 percent of the public say President Trump and Republicans in Congress are to blame for future problems with the ACA, since they are in control of the government.


Trump administration will defray cost of Florida refusing Medicaid expansion was originally published in ThinkProgress on Medium, where people are continuing the conversation by highlighting and responding to this story.