Florida governor hopefuls split on health care

DeSantis, Gillum at odds as reforms stall in Legislature

TALLAHASSEE – Republican Ron DeSantis hasn’t yet unveiled a detailed health care plan, and the biggest proposal Democrat Andrew Gillum supports will be all but impossible to get through the GOP-controlled Legislature.

The nominees for Florida governor disagree about the Affordable Care Act, or Obamacare, with DeSantis criticizing the costs, taxes and requirements that he thinks hurt businesses and consumers. Gillum, meanwhile, wants to expand Medicaid under the law to get more coverage for Floridians, something DeSantis opposes.

Whoever wins will have trouble getting any health plan through the Legislature, where a political stalemate over the issue has formed in the past five years.

Gillum also supports something state lawmakers likely would have no say in at all:

Medicare for All, a federal bill backed by Sen. Bernie Sanders to provide universal health care coverage paid by the government.

“When I’m governor, my administration will avail itself of every tool at our disposal to compel the Legislature to expand health care access to millions of Floridians,” Gillum said in an emailed statement. “I will fight for Medicaid expansion, Medicare for All, and essential protections for women’s health care and pre-existing conditions — while my opponent wants to make this crisis even worse by stripping these essential protections and refusing to expand Medicaid.”

The Medicare for All bill hasn’t moved in the Republican-controlled Congress.

In Tallahassee, the Democrats are holding out hope of gaining enough seats in the state Senate for a 20-20 split of that chamber, but they are outnumbered 75-41 in the House and highly unlikely to flip that chamber this November.

Gillum has spoken of trying to join with other large states like New York to provide universal coverage in lieu of federal action, but there are few details of what that would entail, how much it would cost and where the money would come from.

“I don’t see that quite hap-

pening in the next year or two but it’s getting more traction in the country as a whole,” said Louisa McQueeney, program director for Florida Voices for Health, a health-care expansion advocacy group.

Gillum’s plans for breaking the political stalemate and getting Medicaid expansion through the Legislature are also unclear. He believes his veto power as governor will force Republican leaders to the table, but there’s also the possibility of using executive orders or proposing a ballot measure to make an end-run around lawmakers.

Medicaid funding is $29.6 billion in the current budget, about a third of the $88.7 billion spending plan, and GOP lawmakers have focused on reducing costs in the program rather than expanding coverage, although most of the money comes from the federal government. Under the Affordable Care Act, Medicaid expansion would be 90 percent funded by Washington.

DeSantis’ campaign says he will unveil a detailed health care plan in the next two weeks. He has consistently opposed Obamacare, voting to repeal it many times as a member of Congress. He’s also opposed to Medicaid expansion, which would provide coverage to 700,000 more Floridians who earn up to138 percent of the federal poverty level, at a cost of $6 billion a year.

The program, which pays

for health care for the poor, elderly and those with complex medical needs, wasn’t intended for able-bodied adults who would get coverage under expansion, he said. Instead, he wants to rely on an improving economy with better-paying jobs that will help people afford coverage.

“We’ve got to increase access and drive down costs on health care,” DeSantis said in an email. “The best way we can do that is to make sure we are creating an environment where everyone has a great education that leads to a job where they are covered or they have the ability to buy their own insurance in the market.”

DeSantis also indicated he would back proposals to install direct primary care models, in which patients pay a monthly rate directly to doctors and cut out insurers. He said he would expand telemedicine and ease regulations for building new hospitals. Such policies would add private-sector competition and lower prices, he argues.

But DeSantis would face his own political hurdles in getting those ideas through the Legislature. Similar bills have been pushed by House Republican leaders in recent years, only to fail to make it through the more moderate Senate, where critics contend they would erode quality of care and lead to higher costs.

grohrer@orlandosentinel.com or (850) 222-5564