The Akerman Healthcare Practice Group, as part of its ongoing informational blogs and Practice Updates, will be publishing a series of articles, each outlining a significant healthcare industry issue from 2018, with an eye towards what to expect in 2019. The following is the third in our series – The Year in Review/The Year Ahead:

One of the more significant “non-events” of 2018 was Florida’s continued rejection of the call for Medicaid expansion under the Affordable Care Act – a/k/a Obamacare. Florida remains one of 17 states that has not expanded Medicaid. Last debated in 2015, the Governor and Legislature of Florida have shown little interest in pursuing Medicaid expansion over the past few years.  This comes despite a significant increase in the number of uninsured in the State, and a projected loss over 10 years of approximately $66 billion dollars. A recent study by the non-partisan Urban Institute found that an expansion of Medicaid in Florida would cover an additional 650,000 lives and lower the State’s uninsured rate from 15.7 percent to nearly 11 percent. And, while a poll of Florida residents indicated that about 68 percent favorably support expansion of Medicaid, Republican leadership of the State seemed more focused in 2018 upon alternative measures such as block grants, and premium assistance.

The reasons often cited for resistance to Medicaid expansion are varied. Republican lawmakers in the state argue that Florida simply cannot afford to expand this costly program, and that the promises of continued federal funding, currently at 90 percent of realized costs, cannot be relied upon.  Incoming House Speaker, Jose Oliva has gone on record as stating “The only thing expanding Medicaid would do, is to create further pressure on a system created as a safety net to help low-income people and to subsidize some elderly care. It was not designed to do what people are trying to get it to do.” While Florida’s Democratic leaders argue for such expansion, its Republican leaders remain firmly committed against it. Because of this, despite what appears to be growing public support, Medicaid expansion in Florida seems unlikely to see success in the coming year absent a significant change of position by Florida’s lawmakers.