Medicaid expansion, Florida's best Rx for looming healthcare crisis | Opinion

Qualified kudos to Florida Senate President Kathleen Passidomo. At least she's addressing problems facing the nation's fastest growing state, unlike other elected officials who seem content with waging counterproductive culture war campaigns. As she laid out in her Nov. 9 Live Healthy memo, Florida will need more maternity wards, nurses, physicians and health services for the elderly.

"It is clear to me that we have work to do to make sure Florida's healthcare workforce is growing — just like the rest of our state," Passidomo correctly stated.

Florida has more than 21 million residents, with 800 new arrivals daily, and has long been home to one of the country's oldest populations. That alone should be ample justification for state leaders to make access to health care a priority. We'd be remiss, however, if we didn't suggest a change that would provide huge benefits — Medicaid expansion.

Related Opinion: Your Turn: Medicaid cuts leave big hole in area healthcare services

Yeah, yeah we know. Florida had its chances but remains one of only 10 states that hasn't expanded Medicaid. Former Gov. Rick Scott and many Republicans in the Florida Legislature say expansion is too big a move with an already overspending federal government. So yes, the ship on Medicaid expansion in Florida might have sailed but Passidomo would be wise to reconsider, given the program's many benefits to the other 40 states.

The infusion of federal funds on Florida's healthcare infrastructure is a compelling reason to reconsider. Medicaid expansion requires the federal government pay 90% of the cost in covering newly insured individuals. The state pays 10%. The 2021 American Rescue Plan provides more incentives — another 5% match of federal funds for two years if the remaining holdout states adopt the expansion. Currently, the federal government only pays 60% of the program's costs with Florida paying 40%. Expansion would help 1.5 million more Floridians gain access to healthcare and would give the state resources to provide it.

Medicaid expansion has helped hospitals, particularly rural ones, that used to dip into their resources to cover healthcare for the uninsured. They've seen reductions in uncompensated care costs of 45%, according to the Center on Budget and Policy Priorities. The reduction in non-expansion states isn't as good — only 2%.

Other expansion benefits: More low-income adults visit their doctors; premature deaths among older adults are down. States have also seen reductions in the number of low-income adults struggling to pay their medical bills, a statistic that reflects a solid boost for state economies.

Passidomo prescription questionable

Passidomo has a clear grasp of the state's healthcare problems: Florida's rural areas need more healthcare providers. Emergency rooms in the state's urban areas are often overutilized because of the difficulty in securing an appointment with a physician for routine checkups.

The data on physicians and nurses isn't all that encouraging either. The supply of healthcare professionals isn't keeping up with the state's growth. According to Passidomo's memo, estimates indicate a potential shortfall of nearly 18,000 physicians by 2035. State licensure data show the average age of the 58,062 full-time physicians actively practicing here is 53; one-third of them are over 60. It's a similar story with nurses. By 2035, the state will have a shortfall of 37,400 registered nurses and 21,740 licensed practical nurses.

Passidomo believes technology and the free-market principles of the private sector are the remedies that will restore healthcare in Florida. She's already marshalled the members of the Florida Senate to hold hearings and craft legislation with the idea of improving patient outcomes, increasing efficiency and expanding access to health and medical care.

"Access to healthcare is important at every phase of life," Passidomo asserts in her Live Healthy memo. "Insurance, including Medicaid and Medicare, does not guarantee access. Even Floridians with great insurance face barriers to care."

Point taken about the barriers, which is the gist of our concerns. But she misses the big point: Efficiency, technology and private sector principles have their limits if the money isn't there. The Florida Senate might produce a robust bill but its efforts would go much farther if state leaders re-evaluated how Medicaid expansion would help Florida and then became the 41st state to adopt it.

This article originally appeared on Palm Beach Post: Latest healthcare Rx falls flat without Medicaid expansion