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Florida Children's Health Advocates Ready to Fight for Medicaid Expansion, Again

Khalil Abdullah, Special to the Informer from New America Media | 7/2/2013, 3 p.m.
Courtesy of medicaid.gov

States, collectively, seem to face a universal problem of identifying children who are eligible for health care coverage. School enrollments are an obvious source of obtaining records, but Merrell pointed out that even once identified, retention of those children in a treatment regimen is also problematic.

“Even if children have coverage, unless the parents are covered, they are less apt to bring them in for appointments,” she said.

“What we know and what the research shows is that uninsured children are more likely to become insured when their parents become insured,” agreed Nicholas Duran, health care coordinator with The Children’s Movement of Florida.

Duran, who is leaving his position to work for Enroll America, a non-partisan organization that will focus on educating the public about the state’s federally mandated health insurance exchange, thinks he will be able to leverage public support for Medicaid expansion in his new role. Translating public awareness into civic action, he says, will be crucial to ramping up pressure for enactment of Medicaid expansion when the legislature reconvenes in 2014, or if they are called into a special session.

“Many people don’t know what to do, but ask, ‘How can I help?’” Duran said. “The answer is constituents going to their elected officials and letting them know how this policy impacts their lives. The people have to realize that their voice does count.”

Leah Barber-Heinz, advocacy director of Florida CHAIN, also views the run-up to the looming Oct. 1 medical insurance exchange as an ideal time to better inform the public about Medicaid expansion. She said a more engaged public could provide the push needed to move the legislature forward. Barber-Heinz noted that the Republican-controlled Senate had passed a bill in support of expansion.

“Sen. Joe Negron’s bill was just what we needed and would have provided the state funds to draw down federal money,” she said, referring to the money Florida would have had to commit in three years after receiving 100 percent of federal funding for Medicaid expansion in 2014 through 2016.

While Democrats rallied to support enactment in both chambers, even on the House side, Barber-Heinz said her organization also was pleased to recognize Republican state Rep. Mike Fasano as a champion of Medicaid expansion.

Impact of term limits

Yet Fasano’s very presence in the legislature speaks to one of the obstacles health care advocates in Florida encounter: the impact of term limits. First elected to the Florida House, Fasano was later elected to the Senate. Term-limited after two four-year stints, he ran for and won his old House seat in 2012.

Typically, however, unlike the experience Fasano brings to the legislative process, the institutional memory about a policy issue follows term-limited legislators out the door. When term limits occur, “you have to start over with the education of new legislators,” observed Barber-Heinz. “There’s a great deal of education that goes into public policy, especially in health care because it’s very complicated.”

Karen Woodall, executive director of Florida Center for Fiscal and Economic Policy, agrees. “Term limits have damaged the process because the legislators want to become leaders,” she explained, but with an eight-year cap, the path to leadership is through toeing the line of the incumbent leadership’s expectations, not through developing a mastery of policy. She added that outside money flowing into the state to fund anti-Medicaid expansion efforts has helped impede the process.