A feud over Medicaid expansion that stretches from Tallahassee to the White House means the Florida Legislature may not pass a budget by the time the session ends on May 1. PolitiFact Florida has been fact-checking the fight over whether more poor Floridians will be able to qualify for heavily subsidized health insurance.
The federal government is offering billions if Florida expands Medicaid, paying 100 percent of the expansion at first and gradually downshifting to 90 percent in later years. The program currently eats up a sizable portion of the state budget.
The state Senate has supported the idea of some type of expansion, while the House remains opposed. Gov. Rick Scott has taken different positions on Medicaid over the years, but has settled into opposition during the session. He’s upped the ante on that by declaring he intends to sue the federal government.
The budget hole and ‘LIP’
Scott said he wants to sue the federal government for ending a program called LIP, which stands for Low Income Pool and is a fund that goes to Florida hospitals for treating low-income patients. Without LIP dollars, Florida faces a $1.3 billion budget gap. Scott has said the federal government is abandoning LIP, that "the same federal government that offers some money for a program is walking away from another health care program."
Scott has a point; the federal government did say it would stop paying for the program. But Washington warned Florida in April 2014 that it would bring LIP to an end.
But that obscures two important points. Experts told us that the state had time to evaluate the program, make changes and address funding. And, while federal LIP funding is discretionary, Medicaid money is guaranteed by law. That law is unlikely to change anytime soon. We rated Scott’s statement Half True.
Medicaid and the budget
How much does Medicaid take out of the state budget? Close to 30 percent, said Florida Chamber of Commerce President and CEO Mark Wilson at a committee hearing in March. That makes it "the biggest expenditure at the state," he said.
The 30 percent figure is correct if Wilson counts both the state and federal dollars that go toward Medicaid, and it is the biggest expenditure. However, if we only count state dollars, then education eats up a bigger piece of the budget. We rated his claim Mostly True.
Scott’s changing positions
Scott initially opposed Medicaid expansion, but in 2013 he announced that he decided to support it, earning him a Full Flop on our Flip-O-Meter. But ultimately he didn’t lobby for it, and the Legislature ignored the idea.
More recently, Scott suggested the state should not expand Medicaid, saying at the beginning of April that it would be "hard to understand how the state could take on even more federal programs." Once again, he made a dramatic about-face and we gave him a Full Flop
Health outcomes for Medicaid patients
When constituents send an email to House Rep. Richard Corcoran asking for Medicaid expansion, he sends back this reply:
"The largest national study, conducted by the University of Virginia, found that Medicaid patients were 97% more likely to die than those with private insurance."
Corcoran, one of the most vocal opponents of the expansion in the House, was citing a 2010 University of Virginia study that looked at Medicaid patients who underwent surgery, not all people in the program. Experts we spoke to -- including one of the study’s authors -- said it’s a misleading statistic to cite. While it’s accurate to say Medicaid patients who undergo operations have higher odds of dying than those with private insurance, it’s because they are sicker and tend to wait until the last minute for care, not because the program is inadequate. Other studies show using Medicaid improves access and quality of life for many patients, or at the very least doesn’t hurt them. We rated the statement Mostly False.
House Speaker Steve Crisafulli, R-Merritt Island, opposes the expansion and suggested voters feel the same way, saying, "Medicaid expansion isn’t necessarily a very popular issue on the street."
He was speaking broadly about how constituents don’t want the expansion. We found that several polls show Floridians favoring the expansion, although results vary depending on how the questions are worded. A recent conservative poll found that Republicans don’t like the expansion by a wide margin. Taken together, those numbers present a more nuanced picture than what Crisafulli suggested. We rated the statement Half True.
During the 2014 governor’s race, former Gov. Charlie Crist criticized Scott for the state’s failure to expand Medicaid, saying an expansion would create jobs. "In addition to the $51 billion it would bring to the state over the next 10 years, some studies indicate it would create about 120,000 jobs," Crist said during a debate.
Crist was referring to one study done for the Florida Hospital Association, a supporter of Medicaid expansion. That study predicted about 120,000 new jobs. But other studies predicted far fewer jobs. We rated Crist’s claim Half True.
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Miami Herald/Tampa Bay Times, "Gov. Rick Scott sues feds over health care money, Medicaid expansion," April 16, 2015
See individual fact-checks for additional sources