Health care spending was the defining issue of the 2015 Florida legislative session.
The Florida House and Senate were miles apart on the issue, and the disagreement sent the regular session to a screeching halt earlier this month.
On Monday, lawmakers will return to Tallahassee for a special session to try to pass a budget, but lawmakers appear no closer to an agreement on health spending, especially when it comes to an alternative to Medicaid expansion.
Earlier this week, Senate President Andy Gardiner offered a revamped proposal to offer health coverage to 800,000 Floridians, but the House and Gov. Rick Scott responded with a familiar refrain: they want no part of Medicaid expansion in Florida.
Scott said the proposal would cost the state $5 billion over 10 years, and House Speaker Steve Crisafulli said he doubted Florida would win approval for some of the requirements from the U.S. Department of Health and Human Services. He said the state would instead be left with a "costly and inefficient entitlement program."
WUSF’s Carson Cooper took a closer look at how the special legislative session came to be. He talked with Susan MacManus, a political science professor at the University of South Florida; and William "Windy" March, who covered the Florida legislative session for the Associated Press.
MARCH: Well, it has to do with an impasse over health care, and the budget between the House on one side, and the somewhat, slightly less-conservative Senate on the other side.
To get down into the nitty gritty details of it, the Senate is in favor of expanding health care for low income people under the Affordable Care Act – also known as Obamacare. The House opposes that.
Whether that’s done or not affects, of course, how the budget is put together, and the result of this is neither side would give an inch. They arrived at an impasse, and the result was they were unable to agree on a budget.
COOPER: Now, the Senate plan is not a true Medicaid expansion. It does rely on federal money, but it would go into private plans in Florida. Is it sort of a Medicaid expansion?
MARCH: It’s kind of a Medicaid expansion. It’s aimed at helping the same kind of people that straight Medicaid expansion would help, but the Senate partisans of that plan will insist to you that no, it is not Obamacare, and no, it is not Medicaid expansion. It’s a program that uses private insurance that people could buy through a state-run exchange, and it has work requirements, and requirements for co-pays and premiums that Medicaid doesn’t have.
COOPER: So, the patients would have some skin in the game in that?
MARCH: That’s the idea.
COOPER: Florida House Speaker Steve Crisafulli said that most Floridians don’t care for this expansion. They don’t want Medicaid expansion. Was he on the mark with that? Or is he overstating a resistance to Obamacare in Florida?
MACMANUS: Well, Obamacare nationally and in Florida has never had a majority of the electorate say that they support it, but it’s been around 50 percent or so, 52 percent. The problem is that you can make those claims, but the polls have been all over the map, and the wording that’s used can create different results. And we haven’t seen any consistent, clearly wording polling that reflects the choices on the table.
COOPER: Back in the Don Gaetz-Will Weatherford days, Speaker Weatherford was totally against Medicaid expansion, and so President Don Gaetz pretty much said, hey, if it’s not going to fly in the House, why even bother taking it up in the Senate? Now, this time, the Senate did not capitulate. Why the difference this time?
MARCH: Well, it’s just a matter of the opinions of the president of the Senate, Andy Gardiner, and his estimation of the opinions of the members of the Senate and what they ought to do.
Late in the session, both sides, both Senate President Andy Gardiner and House Speaker Steve Crisafulli, held meetings with their Republican caucus members, who are of course the majority in each house, to line their troops up to whip them into line behind their respective positions. Neither side would give an inch.
For the House, that maintains the position they’ve had for the past couple of sessions. For the Senate to insist this strongly on the issue is what’s new and different, and my suspicion is that you’ll see the Senate cave in the special session.
Lottie Watts is a producer/reporter with WUSF in Tampa. WUSF is a partner with Health News Florida, which receives support from the Corporation for Public Broadcasting.