Medicaid already takes up about a third of Florida’s budget, but if Republicans in the state Senate have their way, the program will be expanded.
And that’s only part of the story taking place in The Sunshine State. There are potential conflicts of interest — and even the possibility of a looming government shutdown to deal with.
Some quick background. There’s a budget standoff over Medicaid expansion. Both houses are controlled by Republicans — but the upper chamber favors expansion, while the lower chamber vehemently opposes it. Gov. Rick Scott has been on all sides of this issue, but he is now arguing that the Obama administration (as the Tampa Bay Times describes his position) is “trying to coerce Florida into expanding Medicaid by ending the so-called Low Income Pool (LIP),” a program that provides funding to “safety-net hospitals and county health departments.”
Without knowing whether or not they can count on LIP funding, Florida’s part-time legislature can’t pass a budget. And, theoretically, if they don’t pass a budget by the end of June, the state government would shut down. (The last time a legislative crisis of this magnitude occurred was 1992. Florida Democrats controlled both chambers of the legislature and the governor’s mansion. Within a few years, Jeb Bush would be the governor, and Republicans would control both chambers.)
This brings us to the possible conflicts of interest. As previously stated, Republicans in the state senate support Medicaid expansion, which might sound odd until you realize that a few of them — including the Senate president — are on the payroll of hospitals. As Gary Fineout observed in the Saint Peters Blog:
During the recently-concluded legislative session, Senate President Andy Gardiner constantly warned about the threat to the state’s hospitals if they were to lose more than $1 billion that now comes from the federal government.
There’s a good reason Gardiner understands hospitals: he works for one.
As Fineout writes, Gardiner has brushed off the criticism: “I think it’s almost more irresponsible if I say ‘I see that problem over there but I ‘m not going to touch it because I work in health care,’” he said. At the very least, it doesn’t look good.
According to his bio, Gardiner is vice president for external affairs and community relations at Orlando Health. But he’s not alone. Senator Denise Grimsley is listed as a “Florida Hospital Wauchula Administrator,” and, according to his bio, Sen. Aaron Bean (click on “About Aaron“) works for Shands Jacksonville “as the relationship development officer.”
Maybe it’s a coincidence, but it is pretty amazing that a state with a Republican governor and a legislature dominated by Republicans is on the cusp of expanding Obamacare.
It also calls into question the supposed virtues of a part-time legislature. Florida legislators make less than $30,000 a year, so you either end up with rich people representing you — or people who have to work another job. And guess which kinds of industries love to hire politicians?
Small government conservatives like the idea of a part-time legislature for obvious reasons, but there are unintended consequences. In this case, it very well might be that a Republican-dominated Florida legislature ends up expanding Medicaid. Now that would be ironic.