Having failed to convince the Florida Legislature to expand Medicaid, health care reform advocates are pressing Congress to expand eligibility for the program in the infrastructure reconciliation measure being crafted this month.

What You Need To Know

  • Florida health care reform advocates are asking Congress to expand Medicaid eligibility using the infrastructure reconciliation measure

  • This comes after the Florida Legislature refused to expand Medicaid in the state

  • Going through Congress would amount to an end-run around Tallahassee lawmakers set on leaving Medicaid as it is

Such a move would amount to an end-run around Tallahassee, where Republican leaders have repeatedly declined to accept more than $50 billion in federal funding to expand the government-run health care program for the poor.

House Republicans have been particularly adamant about rejecting the cash, warning the state could be forced to shoulder much of the cost of expansion if Washington were to one day reconsider its commitment to cover 90% of the bill.

In a recent letter to House Speaker Nancy Pelosi, members of Florida's Democratic congressional delegation called for integrating expansion in the $3.5 trillion reconciliation bill. They suggested raising the income eligibility level to qualify for Medicaid and allowing local governments to pull down a portion of the expansion funding to add residents to the Medicaid rolls.

"The Florida Legislature is steeped in partisanship on this issue, and we in Washington plan to go around them to provide health care," Rep. Darren Soto (D-Kissimmee) said during a press conference on the issue.

It is estimated that nearly 1 million Floridians fall within the Medicaid "eligibility gap," with incomes that are too high to qualify for Medicaid yet not enough to allow them to afford private health insurance.

Alison Holmes is one of those Floridians. She is a full-time caregiver to her severely disabled son, JJ, and isn't currently eligible for Medicaid despite desperately needing coverage.

"My health is failing, but my bigger fear is that JJ's going to end up in a state-run facility because I physically won't be able to lift him anymore," she said. "And I can't get the health care to keep myself fit enough to keep lifting."

Florida is one of just 12 states that have declined to expand Medicaid in line with the Affordable Care Act. Washington recently sweetened the deal for non-expansion states, with Congress voting to cover the full cost of expansion for the first three years — one year longer than had initially been offered — and 90% thereafter.