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Impact of Medicaid expansion remains elusive

State economists Tuesday agreed to disagree when it comes to the financial impact that a proposed constitutional amendment to expand Medicaid would have on Florida.

Economists, meeting as the Financial Impact Estimating Conference, could not reach consensus on the impact of the proposed amendment on the state budget and overall economy.

The decision means that if the amendment appears on the November 2020 ballot, voters won’t see a 150-word summary explaining the impact. Instead, they would see a statement that says, “The financial impact of this measure, if any, cannot be reasonably determined at this time.”

It is the first time members of the Financial Impact Estimating Conference have been unable to reach an accord, according to Amy Baker, coordinator of the Legislature’s Office of Economic and Demographic Research.

Baker said Medicaid is a complicated issue and determining the impact of an expansion of the health-care safety net program isn’t an easy task.

“What you personally feel is probable is different for every individual,” Baker told the News Service of Florida following the panel’s meeting. “And there were many, many different moving parts to this.”

Baker’s team had come up with estimates that showed it would cost the state roughly $339 million to expand Medicaid to low-income uninsured childless adults. But the expansion would draw down nearly $4.7 billion in federal money.

The overall effect on the budget would be a nearly $4.38 billion positive increase, according to Baker’s analysis.

But the assumptions were based on complex calculations and weeks of economic analyses looking at issues such as the number of newly eligible people who would actually enroll in Medicaid and the movement to Medicaid of an estimated 593,525 people who get coverage on a health-insurance exchange that is part of the federal Affordable Care Act.

Disagreements also centered on the number of people who would be affected by the proposed amendment. Baker’s estimates showed that 1,072,483 people would be impacted by the program.

Baker’s team predicted that 29 percent of the population that would become newly eligible for Medicaid would actually enroll in the program, or 245,842 people.

But Eric Pridgeon, who is the House’s top budget staff member and serves on the Financial Impact Estimating Conference, thought the figure was too low. Moreover, Pridgeon was concerned about last-minute testimony offered by the state Office of Insurance Regulation.

“It seems like the more digging we do the more questions pop up,” Pridgeon said.

Pridgeon’s comments were echoed by panel members representing the Senate and the Governor’s Office.

The political committee Florida Decides Healthcare is trying to get the proposed constitutional amendment on the 2020 ballot after years of the Republican-controlled Legislature rejecting a proposed expansion of Medicaid eligibility. Such an expansion is allowed under the Affordable Care Act, better known as Obamacare, with the federal government picking up most of the tab.

It remains unclear whether Florida Decides Healthcare will gather enough petition signatures to qualify for the 2020 ballot. A spokesman said recently the initiative might be pushed backed to 2022.

Anne Swerlick, a longtime health care advocate who is working with Florida Decides Healthcare, expressed disappointment Tuesday that the Financial Impact Estimating Conference couldn’t come to an agreement.

“While we appreciate all the hard work of the estimating conference, we’re disappointed that they could not reach consensus on the millions of dollars of savings Florida could realize if it expanded Medicaid,” Swerlick said. “Multiple studies show how expansion increases access to affordable health care, improves health and financial security for families, and positively impacts state and local economies.”


Republished with permission of the News Service of Florida.

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