Health Care not an elixir for Florida Democrats

November 8, 2018

By Christine Sexton

TALLAHASSEE --- Florida Democrats pushed health care as a top priority during this year’s elections, hammering Republicans for attempts to repeal Obamacare and the potential loss of insurance protections for people with pre-existing conditions.

Democrats also hoped support for a Medicaid expansion would help foment a “blue wave” that was supposed to wash over the state Tuesday.

After Democratic gubernatorial nominee Andrew Gillum and other candidates for statewide offices were defeated, the “blue wave” looks more like a blue puddle, with health care not giving the Democratic Party the shot in the arm it wanted.

Alan Levine, a key health-care adviser to former Republican Gov. Jeb Bush, said while numerous polls indicated that health care was a top concern with the voters, the words “health care” mean different things to different people.

“When you looked at polling, health care ranked second or third, but you don’t know what that means. To some people, the issue of health care is being very upset because their premiums costs so much,” said Levine, now the president and chief executive officer of the Mountain States Health Alliance, the largest hospital and health system in Northeast Tennessee and Southwest Virginia. “To others, it’s that they don’t have access.”

Florida Republicans have long fought the federal Affordable Care Act, the health care law commonly referred to as Obamacare. And Democrats were hoping to pounce on the health-care records of their GOP opponents. Democrats held regular media conference calls berating Republicans, including gubernatorial candidate Ron DeSantis and Gov. Rick Scott, who challenged Democratic U.S. Sen. Bill Nelson.

DeSantis won Tuesday night, though it became apparent Thursday that a recount might be triggered by the closeness of the race. Scott declared victory in his race against Nelson, but a recount is expected to be required.

Scott, a former health-care executive, was first elected in 2010 on an anti-Obamacare platform and --- with the exception of a brief moment in 2014 --- adamantly opposed expansion of Medicaid benefits to uninsured, childless adults under the federal law.

Working closely with the Florida House, Scott helped beat back the state Senate’s efforts to expand Medicaid in 2015. Later that year, he assembled a task force that examined health-care costs and in 2016 pursued legislation that would have capped what hospitals could charge patients.

This year, the Scott administration asked the federal government to give Florida the green light to eliminate a long-standing policy of retroactively covering hospital and nursing home bills for Medicaid-eligible patients. The policy would save nearly $100 million and impact about 9,000 elderly and disabled patients.

DeSantis, a former congressman, has sharply criticized the Affordable Care Act and government-provided health care.

But a debate in Congress about repealing and replacing Obamacare took place in 2017. And while there were protests across Florida about a possible repeal, that is a lifetime in today’s quick-paced political environment.

“In the news cycle phenomenon, health care is old,” said Florida political expert Susan McManus, adding that the “one-two-three punch” in the gubernatorial election were recent headline-grabbing issues that drove Republican voters to the polls in support of DeSantis. Those issues were the confirmation process of U.S. Supreme Court Justice Brett Kavanaugh, a migrant “caravan” heading toward the United States and allegations of ethical lapses against Gillum.

“Health care just wasn’t as powerful as those other things,” MacManus said.

Because health care is delivered locally, there’s a maxim that health care is a local issue, which could be why it didn’t transcend with voters statewide. But it did play a role in congressional Districts 26 and 27 which were won by Democrats Debbie Mucarsel-Powell and Donna Shalala, respectively.

Mucarsel-Powell, a former associate dean at Florida International University’s medical school, criticized Republican Congressman Carlos Curbelo on a number of issues and told The New York Times that it was his votes to repeal and replace Obamacare that inspired her to run.

Shalala, who was secretary of the U.S. Department of Health and Human Services for President Bill Clinton, served as president of the University of Miami from 2001 to 2015. She won a seat Tuesday that was open because of the retirement of Republican Congresswoman Ileana Ros-Lehtinen.

The South Florida districts are considered ground zero for Obamacare enrollment, with some of the largest number of enrollees in the state and nation. Miami-Dade County had nearly 395,000 people in a health-insurance exchange that is part of the federal law.

“The demographics of a district are important.” Levine told The News Service of Florida. “Take it to the bank. It came into play there.”

Statewide, more than 1.7 million people were enrolled in insurance plans through the federal health exchange this year. Many of them found coverage in the exchange with the assistance of Florida Covering Kids and Families. Located at the University of South Florida College of Public Health, the organization serves as the state’s main navigator for people seeking coverage.

Jodi Ray, director of Florida Covering Kids and Families, held out hope that the 2018 elections could be a turning point for the state’s health-care system. While she is able to help those who qualify for Obamacare policies, another 800,000 people in Florida don’t earn enough money to be on the exchange but don’t qualify for government coverage because the state didn’t expand Medicaid.

“We were hoping that there was a potential to bring that up in the future. That’s a shame that fight may not happen,” she said.