Florida missing out on Medicaid expansion's benefits

In 2011, the federal government began collecting tax dollars to make health insurance affordable for Americans who otherwise could not afford it. Our tax dollars are used to reduce the cost of plans purchased by 1.7 million low-income Floridians through the federal marketplace.

However, the approximately $5 billion a year collected to help very low-income people enroll in Medicaid is not being used for Floridians. The Supreme Court made Medicaid expansion optional, leaving each state to decide.

Florida is one of only 14 states not expanding Medicaid. This lack of coverage for our most vulnerable citizens is reflected in the 2019 U.S. News and World Report rankings of Florida at 48th in the nation for access to care.

Results from states that expanded Medicaid demonstrate enrollees get regular check-ups and are benefiting from routine care. Because of early identification of these issues, enrollees are reducing high blood pressure and cholesterol in an effort to avoid strokes and heart attacks.

Since enrollees are screened regularly, cancer is identified earlier so they can get treatment when it is most effective and easier on the patient. Because of access to primary care, Medicaid expansion enrollees are less likely to use the emergency room.

Infants born in Florida are more likely to die before their first birthday than infants born in 26 other states. Infants born in Florida to black mothers are more likely to die than those born to white mothers. For every two white babies who die, five black babies die.

Medicaid expansion states have lower infant death rates than others and, the greatest reduction in infant deaths is among black babies. On the average these states have a lower pregnancy-related death (maternal mortality) rate than others, so it is not surprising the maternal death in Florida is higher than the national average. Medical professionals think the health of the woman before pregnancy may be as important as prenatal care, which probably accounts for the improved pregnancy-related outcomes.

People who live in states that have not expanded Medicaid are more likely to smoke. People who go for regular medical check-ups are referred to smoking cessation programs and Medicaid enrollees benefit from the availability of medications that help.

Low-income people are also more likely to suffer from mental health issues. Medicaid offers comprehensive care for mental health, which can be identified during regular health care visits and a referral made to the needed services including medication. States report that 36%-50% of new Medicaid expansion enrollees had undiagnosed depression.

Florida’s death rate from opioid overdose is higher than the national average. Adults eligible for Medicaid under its expansion are more likely to suffer from opioid abuse than other adults.

Florida only offers limited substance abuse treatment due to inadequate funding, whereas Medicaid expansion states use federal dollars to provide comprehensive treatment including medication. In addition, a new study found Medicaid expansion enrollees are more likely to receive treatment for opioid addiction than opioid abusers enrolled in private insurance.

Evidence from other states clearly demonstrates the value of Medicaid expansion as a resource for providing effective, affordable treatment for opioid addiction. Florida talks the talk but to walk the walk, it would expand Medicaid and offer comprehensive treatment for this debilitating condition.

As an additional incentive to accepting our tax dollars are reports from other states about the financial benefits of Medicaid expansion. Enrollees are less likely to declare bankruptcy, have more disposable income and are able to look for, find and keep, and find better jobs.

It is estimated that if Florida accepted Medicaid expansion, the state would have more than $500 million to spend. Other states also report Medicaid expansion represents a general economic stimulus that also increases the number of jobs.

Barbara Glass is president of the League of Women Voters of Alachua County/Gainesville.