Florida Sen. Annette Taddeo

Florida state Sen. Annette Taddeo, D-Miami

A month after a proposed constitutional amendment to expand Medicaid under the Affordable Care Act (ACA) was withdrawn from the 2020 ballot, a South Florida Democrat has pre-filed a resolution asking lawmakers to put it back.

Sen. Annette Taddeo of Miami Thursday submitted Senate Joint Resolution 224, which requests the Legislature ask voters to consider a measure to “provide Medicaid coverage to persons under age 65 with an income equal to or below 138 percent of the federal poverty level.”

Florida lawmakers have twice rejected expanding Medicaid under the ACA since 2014, preferring to seek block grants to subsidize its expenditures in providing health care insurance for low-income residents.

The proposed amendment would require the state’s Agency for Health Care Administration (AHCA) submit an expansion plan to Gov. Ron DeSantis by April 1, 2021.

DeSantis would file his response by July 1 and the AHCA present its final plan by Oct. 1 – a month before the Nov. 4, 2020 election.

Taddeo’s resolution must be approved by 60 percent super-majorities in both Republican-controlled chambers, meaning it has little chance of adoption.

However, in an election year where health care is certain to be a contentious issue, Democrats could use the resolution’s dismissal by Republican leaders as campaign fodder.

On Aug. 9, the political action committee Florida Decides Healthcare announced it was no longer seeking to get its proposed constitutional amendment to expand Medicaid under the ACA onto the 2020 ballot, instead targeting 2022.

Committee spokesman Dan Newman said restrictions in the petition-gathering process adopted by the Legislature in a “midnight amendment” as time expired during the 2019 session “created confusion and uncertainty in the funding community,” forcing the group to push the measure back to 2022.

State law requires petition drives collect 76,632 signatures from verified voters to trigger a Supreme Court review. As of Thursday, Florida Decides Healthcare had gathered 85,031 signatures to qualify for that review.

If justices sign off, supporters must submit 766,200 signatures by Feb. 1, 2020, to get on November’s ballot.

However, rules adopted during the 2019 session essentially extend the state’s voter registration system for absentee ballots to petition-gathering, requiring petition sponsors have their own numbered, serialized petitions provided by county elections offices, raising the cost to gather, present and validate signatures to about $4 each.

Petition-gatherers say now they’ll need at least 1.1 million signatures to ensure 766,320 are verified and will need to finish collecting signatures by the end of 2019 to give elections supervisors the required 30 days to verify them before Feb. 1.

“The voter-led campaign to expand Medicaid isn’t going anywhere,” Newman said. “We were hustling to put health care directly on the 2020 ballot because it is clear that Floridians overwhelmingly support Medicaid expansion, but state legislative changes at the end of the session just made that a hill too steep to climb.”

The newly-imposed requirements also require prospective measures undergo an analysis by the Financial Impact Estimating Conference [FIEC], a panel of state economists.

During three FIEC hearings on the proposed measure in July and August, proponents maintained expanding Medicaid eligibility under Obamacare would provide an additional 960,000 Floridians access to health care, save state taxpayers nearly $200 million and generate $400 million in tax revenues annually for state and local governments by 2022, paid for by federal taxpayers.

Anne Swerlick, senior policy analyst with the Florida Policy Institute [FPI] representing Florida Decides Heathcare, presented two reports that documented “the experience of the 36 states have opted for Medicaid expansion under the ACA,” noting unlike in 2013 and 2015 when the Legislature previously considered expansion, there’s now “a substantial body of research … to support our findings.”

Right now, the state’s share in Medicaid funding is 38.53 percent. By allowing single adults who meet federal income eligibility requirements to enroll under the ACA, the state’s share of Medicaid funding would be 10 percent, she said.

The infusion of a projected $4 billion in federal Medicaid money by 2022 would spur “increased economic activity” and “trigger creation of new jobs,” Swerlick said.

FEIC economists, however, came to different projections. While they calculated the expansion could, indeed, draw down $4.7 billion in additional federal Medicaid money, the proposed expansion would still cost the state $339 million a year.

The FEIC estimated 593,525 people who now participate in the ACA’s health-insurance exchange would simply drop that subsidized coverage for Medicaid.

And instead of 960,000 qualifying under ACA expansion as sponsors estimated, the panel projected at least 100,000 to 250,000 more people would be eligible — an estimate some said was still too low.

Ultimately, the FEIC decided its statement in the measure’s ballot language would be its fiscal impact was “undetermined.”