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In Florida, Midterm Elections Hold Faint Hope For Medicaid Expansion

Can the deep-red Florida Statehouse observe Virginia and increase Medicaid?

Highly unlikely anytime quickly, many state political analysts say.

It’s been three years because the Florida legislature final debated — and overwhelmingly rejected —Medicaid enlargement below the Affordable Care Act.

Republicans — who’ve managed the governor’s workplace and each legislative chambers for practically the entire previous twenty years — have proven no curiosity since then in pursuing the coverage that might make about 660,000 uninsured adults eligible for the federal government insurance coverage program for the poor.

While Democrats are anticipated to realize Statehouse seats within the midterm election, it’s unlikely they will seize sufficient to make a distinction. That’s very true within the House, the place the GOP holds a 76-41 majority, with three seats vacant. Six GOP House members don’t even face an opponent.

“I don’t see Medicaid expansion having much of a chance,” stated Carol Weissert, Florida State University’s chair of civic training and political science. “It’s a combination of the political reality on the ground, and I don’t see a huge push for it around the state.”

While well being care is usually an enormous difficulty in retiree-heavy Florida, gun legal guidelines and training are prone to play heavy on voters’ minds this fall following the February bloodbath at Marjory Stoneman Douglas High School in Parkland, Fla., the place 17 folks have been killed.

Susan MacManus, a political science professor emeritus on the University of South Florida in Tampa, stated one “long shot” for the Democrats’ fall election prospects is a rising share of youthful voters. They are typically extra supportive of increasing Medicaid, she stated.

Although Election Day continues to be greater than three months away, enlargement proponents are unlikely to tug off a repeat of what occurred within the Virginia House of Delegates election final November, Weissert stated. Democrats there captured 15 GOP seats and got here inside one vote of controlling the meeting.

That shock helped persuade a few GOP lawmakers to affix Democrats to push Medicaid enlargement by a legislature that had staunchly rebuffed it for 4 years. Many freshman Virginia Democratic lawmakers campaigned on this difficulty and different measures that might make well being care extra accessible.

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About 400,000 folks in Virginia are anticipated to realize protection from enlargement.

Florida is certainly one of 17 states that haven’t expanded Medicaid since 2014, and solely Texas has extra residents who may benefit. An enlargement would drop Florida’s uninsured fee from 15.7 percent to nearly 11, in response to the nonpartisan Urban Institute.

Republican leaders in Florida have cited varied causes for opposing this step. They say the state can’t afford it. They assert that Florida can’t belief the federal authorities to pay for a minimum of 90 p.c of prices for the newly eligible. They additionally argue that Medicaid protection shouldn’t go to nondisabled adults as a result of the state is straining to cowl youngsters, pregnant girls and other people with disabilities.

In wanting on the difficulty within the gubernatorial races, the excellent news for enlargement proponents is that Gov. Rick Scott, a Republican who opposed the well being regulation and briefly supported Medicaid enlargement then opposed it, is leaving workplace.

Scott is working for the U.S. Senate in opposition to incumbent Democrat Bill Nelson.

While the main Democratic candidates for governor again enlargement, the highest Republican candidates, together with state agriculture Commissioner Adam Putnam and U.S. Rep. Ron DeSantis, are firmly in opposition to it. The state’s major election is Aug. 28.

But if a Democrat might acquire the governorship, it could a minimum of give Medicaid advocates some negotiating leverage, stated MacManus.

“A Democratic governor could have some influence on the legislature down the road,” she stated.

Gregory Koger, professor of political science on the University of Miami, stated the social gathering not controlling the White House normally does properly in midterm elections and expects Florida Democrats to learn. President Donald Trump’s low approval rankings, he added, also needs to assist them.

Although the chances are lengthy, he stated, the GOP’s failure to repeal the well being regulation final yr in Congress may sway some Republicans within the state legislature to vote for enlargement, significantly if the plan included a piece requirement for these gaining protection.

“That could give Republicans political cover,” Koger stated.

Florida voters looking for enlargement will be unable to observe Maine’s lead on a voter referendum on Medicaid till a minimum of 2020.

Maine’s profitable 2017 voter referendum ignited curiosity in different states, together with Utah, Nebraska and Idaho, the place voters are anticipated to handle the measure within the fall.

Jonathan Schleifer, govt director of the Fairness Project, which is directing the ballot initiatives, stated there wasn’t sufficient time this yr to launch an effort in Florida.

“It was premature to do in Florida because we needed a larger runway for the work,” he stated. “It would have been impossible to put together that many signatures.”

Schleifer stated he sees sturdy public assist for increasing Medicaid and hopes that after extra states approve the poll referendum it can make it simpler to perform within the Sunshine State.

Phil Galewitz: pgalewitz@kff.org”>pgalewitz@kff.org, @philgalewitz

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