The Manchin inflation deal omits health care for low-income people

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  • Democrats in Congress are ready to start voting on an inflation deal this weekend.
  • But the deal does not expand health coverage for people with incomes close to poverty level.
  • About 800,000 Floridians will be left uninsured, and the next cover-up may not come until 2024.
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                    When Democrats in Congress announced last year that they were working on a massive spending bill to transform America's social safety net, health care advocates in Florida were optimistic that there might finally be a way to get multi-person medical coverage.

Last week, however, their hopes were dashed. One of the many elements that hit the cutting room in the $ 740 billion compromise of the Democrats’ Reducing Inflation Act was a provision to evade Republican state lawmakers to expand Medicaid to nearly 800,000 Floridians.

The omission comes as a major blow to Florida’s uninsured, particularly at a time when many are worried about a recession and residents are already facing high costs at the grocery store and gas pump, as well as rental bills in increase, health care advocates say.

“It’s definitely a missed opportunity, especially if the whole thing is about inflation and the impacts of inflation,” Scott Darius, executive director of the non-profit defense group Florida Voices for Health, told Insider.

                    Florida is among 12 Republican-led states that refuse to expand Medicaid under the Affordable Care Act, commonly known as Obamacare.  Under the law, states pay 10% of the costs while the federal government collects 90% of the ballot.

Florida isn’t likely to have a chance to expand Medicaid until 2024 at the earliest. Healthcare advocates and Florida Democrats have little faith that Republicans in the state legislature will change their stance against Medicaid expansion, so they hope to put the matter up for a vote in the 2024 election to have voters weigh directly. .

“The vote size is our best chance of getting Medicaid expansion approved,” Senator Shevrin Jones, a Miami Gardens Democrat who sits on the state Senate health policy committee, told Insider.

“This should be the top priority for us, but Republicans have shown us time and time again that they are not interested in what makes sense,” Jones added. “They are interested in what feeds their base.”

                    In 2021, President Joe Biden's $ 1.9 trillion coronavirus bailout package tried to sweeten the Medicaid deal by bearing state costs for two years, but Florida has yet to agree.  Republican Governor Ron.  DeSantis' office told the Washington Post in March 2021 that he "remains opposed to the expansion of Medicaid in Florida."

The governor’s office and several other GOP leaders in the state legislature did not answer Insider’s questions about whether circumstances, such as a recession, could alter their stance on Medicaid expansion.

Republicans have expressed concern over rising health care costs, citing fears that the federal government may one day recover Medicaid payments.

House Speaker Chris Sprowls, a Republican from Palm Harbor, said he thinks Medicaid should only go towards the most vulnerable residents, rather than relying on income, he told the Orlando Sentinel in March 2021.

                    Under Obamacare, people who earn $ 13,590 or less for an individual or $ 27,750 for a family of four qualify to enroll in Medicaid.  This raises objections from Republicans as it does not take into account disability or employment status.

Rev. Vanessa Tinsley, executive director of Bridge to Hope, a Miami-based community organization whose services include a food program, said the narrative about people on Medicaid was not true. Many of the clients it serves have jobs and degrees.

“It’s not about hard work – we have it here – but they work very hard with low-paying jobs,” he said, adding that even though Florida has raised the minimum wage, it hasn’t kept up with rising rents. A major medical problem can evaporate savings or raises, she said.

                      <img class="lazy-image " viewbox="0 0 1 1" data-content-type="image/jpeg" srcs="{"https://i.insider.com/62ea87bbc6987600183c68a5":{"contentType":"image/jpeg","aspectRatioW":3833,"aspectRatioH":2874}}" alt="Bernie Sanders Joe Manchin"/>

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                          Senator Bernie Sanders (I-VT) (L) walks past Senator Joe Manchin (D-WV) during a mark up of the Senate Energy and Natural Resources Committee, on Capitol Hill on May 03, 2022 in Washington, DC .
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                            Kevin Dietsch / Getty Images
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                  </figure><h2>The US version of Biden's agenda cut the price by more than half</h2>For more than a year, Democrats in Congress have been exploring ways to evade GOP lawmakers in Medicaid-pending states.  An estimated 4 million people nationwide who are uninsured would be able to join Medicaid if all states expanded the program, according to a federal government report compiled by the Department of Health and Human Services.

                    The US House's $ 2 Trillion Build Back Better Act passed in November 2021 found a solution to bridge the Medicaid gap.  It would pay the full cost of private health insurance premiums for people with earnings close to poverty level.

But the provision was among many scrapped to create the Inflation Reduction Act, although the bill retained other health policies on drug pricing and private health insurance for higher-income people who would not qualify for Medicaid. .

The bill could still change. Democratic Senator Raphael Warnock of Georgia plans to introduce an amendment to help people who cannot access Medicaid. He will present the amendment during “vote-a-rama”, an amendment voting marathon that could end up changing the final draft of the law. The Senate is considering the inflation deal starting Saturday.

Florida Voices for Health is working with the Southerners on Medicaid expansion to push Congress this week to support the Warnock amendment.

                    But Conservative Democratic Senator Joe Manchin of West Virginia and Kyrsten Sinema of Arizona have been cautious about raising the price of the legislation.  A non-partisan Congressional Budget Office estimate found that the Medicaid idea of ​​the Build Back Better Act could cost the federal government $ 125 billion. 
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                          Florida Senator Shevrin Jones discusses a bill, dubbed the "Don't Say Gay" bill by opponents, just before the bill was voted on during a legislative session at the Florida State Capitol on Tuesday, March 8, 2022, in Tallahassee, Florida.
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                  </figure><h2>"We may have to be creative"</h2>Without a federal solution or immediate electoral vote, the fate of Medicaid rests in the hands of state legislators or voters.

Bridge to Hope’s Tinsley said she is “terrified” of a recession as she already sees people living on the brink. She knows families whose parents cannot marry because their children would otherwise not qualify for Medicaid, people who skip the necessary medications, or fathers with asthma who cannot afford health insurance and are left to borrow their children’s inhalers. .

“The people in my food line were donors and volunteers,” Tinsley said. “Our resources are shrinking.”

                    Not being able to afford health care worsens people's conditions, he said.  And many people across Florida who need to cut back on spending can only do so by lowering their grocery bills, she added.  Often, cheaper foods are also less healthy and this leads to problems like diabetes and hypertension which in turn increase people's healthcare costs. 

DeSantis is running for re-election in Florida and is expected to win as Florida Republicans have outpaced the Democrats in the state of 220,000. Both Democrats running for nominations in the Aug. 23 primary to address him – Rep Charlie Crist and Florida Agriculture Commissioner Nikki Fried – support the expansion of Medicaid.

Jones will face a major opponent on 23 August. If re-elected, he plans to submit a bill to expand Medicaid, he said. In this round, however, he said he wants to try to see if there is a way to come to a bipartisan deal as other GOP-led states have done, particularly after hospitals and health insurers have teamed up behind it. effort.

“We may have to get creative,” he said.

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