Rep. Rudman argues why Republicans should expand Medicaid as Passidomo, others disagree

NAVARRE, Fla. – Rep. Joel Rudman, R-Navarre, expressed why he believes Florida Republicans should lead the charge to expand Medicaid.

Medicaid expansion has been a longstanding debate across the country. Officials like Florida Senate President Kathleen Passidomo, R-Naples, and other Republicans voiced their disapproval of the idea for various reasons.

Medicaid was established in 1965 as a way to provide healthcare to low-income adults, children and the disabled. Each state has the opportunity to expand the program for their residents.

Rudman told Florida’s Voice that one of his main reasons for supporting Medicaid expansion was to help the “huge section of society” that is being “underserved” when it comes to medical care.

“Under current Florida guidelines, the only adults who qualify for Medicaid in the state either are those that are permanently disabled […] or those adults who have dependent children, and even in that situation, those adults must earn less than $3,600 a year,” Rudman said.

“These are people that we would typically describe as you’re ‘working poor,'” he continued. “These are people holding down two jobs. These are single mothers. These are people who are working as your waitresses in your restaurants, but yet their jobs do not offer health insurance.”

“That bar is set extremely low,” he said. “It’s almost as if we’re encouraging those single mothers not to look for work. Because any job they accept is certainly going to pay more than $3,600 a year.”

Florida is one of 10 states that has not expanded Medicaid since the Affordable Care Act was passed in 2010.

“As the only primary care physician in the legislature, I am the only state representative who actually represents boots on the ground in primary care,” Rudman said.

He explained that he has not personally taken Medicaid while working in his medical practice for 17 years due to the “awful” reimbursement rates.

Rudman has also argued that rural hospitals are under a serious “threat” of shutting down if the legislature doesn’t take action and expand Medicaid access.

Florida’s Voice asked Republicans across the state their thoughts on Medicaid expansion. A spokesperson for Passidomo told Florida’s Voice that the senate president does not support it.

“She has opposed it since her time in the House,” the spokesperson said.

”Her priority is expanding Florida’s health care workforce, which is not growing at the same rate as the rest of our state,” the spokesperson added.

Passidomo also released a memorandum where she expressed her concerns about the physician shortage and other healthcare concerns in the state of Florida.

”Our rural areas need more health care providers, so sick and injured Floridians do not have to travel long distances for treatments,” she said. “Emergency rooms in many of our urban areas are over-utilized because often times it takes too long to get appointments for routine medical care.”

The Florida Policy Institute has emphasized several reasons as to why it believes expanding Medicaid in Florida must be done.

”If the state expanded Medicaid to cover adults aged 19 to 64 with income up to 138 percent of the federal poverty level, more than 800,000 Floridians would gain access to coverage, including 400,000 residents stuck in the health care ‘coverage gap,’” the group argued.

The group also said that expansion would lead to $14.3 billion in new federal dollars to the state over a five-year period.

The Applied Economic Research Group also weighed in that the benefits of Medicaid expansion would lead to increased education and employment, as well as decreased bankruptcy, crime and mortality.

However, it also recognized that if every uninsured Floridian applied for newly expanded Medicaid services, it would cost the state $3.6 billion additional dollars.

“Expanding Medicaid would mean a commitment of billions of dollars every year in Florida’s budget,” Rep. Alex Andrade, R-Pensacola, told Florida’s Voice.

“It would also mean subjecting Floridians even more to the whims of the Federal Government,” he said. “After watching the Biden administration try to use CMS and OSHA to force vaccines on every Floridian, I am very wary of any proposal that would result in giving more power over our daily lives to D.C.”

Rudman told Florida’s Voice that if the state expanded Medicaid, it would not result in an overall increase in costs to Florida taxpayers.

“We are not looking to raise taxes or to over-utilize state revenues in this endeavor,” he said. “So what’s important to know when you talk about improving accessibility under Medicaid and increasing eligibility, 90% of that funding actually comes from the federal coffer.”

“So in other words, that money that’s currently being spent in state’s like California, New York, North Carolina, Oklahoma, that money can be directed to the state of Florida. The feds would pick up 90% of the tab,” he affirmed.

Rudman said he looks at what’s happened in other states in regards to addressing the remaining 10%. He explained how other conservative states that have expanded Medicaid, like Louisiana, charge hospitals higher administrative fees in order to make up the difference in costs.

“In other words, in those states, there is no increased revenue being drawn out of state coffers. The system pays for itself, which is the only way I would even consider such an endeavor,” he said.

Santa Rosa County Commissioner James Calkins told Florida’s Voice that he is very concerned about Medicaid expansion. The commissioner explained that communities and local governments have “options beyond Medicaid expansion” to help rural hospitals that don’t require the program’s expansion.

“One way is by investing in telemedicine, which can improve healthcare access for rural folks and ease the financial burden on hospitals,” Calkins said. “Another way is to offer financial perks for healthcare workers in rural areas, ensuring hospitals have enough staff.”

Rudman reaffirmed that he does not plan on introducing any type of legislation relating to Medicaid expansion during the upcoming 2024 Legislative Session.

“I’m afraid that the talk of improving and expanding Medicaid and increasing Medicaid eligibility, I’m afraid that this is somewhat inevitable,” he said.

“And we can either be on the right side of this as Republicans, or we can be on the wrong side of this,” he added. “I would prefer to have conversations down the road where we do a long, hard look at this and we as Republicans can be the party that brings this to our working class Floridians.”