Initial Medicaid Implementation: Florida initially implemented Medicaid in January 1970, the day following the federally imposed “deadline” to implement Medicaid, or the day after previous programs that paid for low-income populations would end. Florida had a fear that implementing Medicaid would lead to the state covering “indigent” care and the state initially did not include a program that would provide coverage to the medically needy population. The state later implemented this program.
Key Medicaid Political Issues: Florida has continued to wrestle with the problem of a high number of people without insurance in the state. In 2005 the state developed a financing arrangement with the federal government to fund uncompensated care costs through a waiver, known as the Low-Income Pool (LIP) program. Part of this waiver also expanded the use of managed care in the state, beginning in select counties and expanding statewide starting in 2014.
Medicaid Expansion Implementation: Florida Governor Rick Scott has been at the center of the Medicaid expansion debate. A former health care executive, Rick Scott’s political career began in earnest through forming an organization to fight the Affordable Care Act. Once in office, Scott helped lead the charge to bring the court case to the Supreme Court and even prior to the decision to allow states to determine whether or not to take the Medicaid expansion he decided to reject any federal funding from the Affordable Care Act, even programs that had been in existence for many years. Scott initially opposed the expansion of Medicaid but prior to his re-election as governor he declared his support for Medicaid expansion. The bill ultimately failed in the state legislature. The state and the Obama Administration spent several years debating, both in court and through policy, the future of the LIP program. The state sued the Obama Administration to maintain the federal matching of the program. The two parties came to an eventual agreement to decrease funding for the LIP program over time. This deal, however, was overturned when the Trump Administration came into office. The LIP program was scheduled to be terminated after 2017 and under the latest waiver, funding will continue through 2022.
General facts about Florida Medicaid:
Medicaid program name: Medicaid
CHIP Program name: Florida KidCare
Separate or combined CHIP: Combination
Medicaid Enrollment: 4.4 million (2016 estimate)
Total Medicaid Spending: $21.8 billion (FY2016)
Share of total population covered by Medicaid: 18%
Share of Children covered by Medicaid: 50% estimate
Share of Medicaid that is Children and Adults: 71%
Share of Spending on Elderly and people with disabilities: 64%
Share of Nursing Facility Residents covered by Medicaid: 60% (estimate)
Expansion state: No
Number of people in expansion: N/A
Work Requirement: No