Alternatives to Medicaid expansion could be more costly

With the Florida House presently unwilling to support Medicaid expansion, legislators are finding inspiration from other states as they try to come up with an alternative solution.

Much of the focus is on Arkansas, which received preliminary federal approval to use Medicaid expansion dollars to purchase private insurance via health exchanges for 250,000 people.

In Indiana, the state wants to adding 300,000 people to its health savings account-based plan instead of Medicaid expansion. Iowa is asking to add an estimated 150,000 people to its low-benefit safety net program instead of Medicaid.

Florida is bigger than all three of these states combined. Roughly 900,000 people hang in the balance as the state debates whether or not it will expand Medicaid.

Avik Roy, a senior fellow at the Manhattan Institute for Policy Research, a conservative think tank, is a fan of the Arkansas plan. He thinks Medicaid is a failed program and the uninsured are better in private policies.

But Roy still has his concerns, what he calls the "$500 billion question." Pointing out that health exchange plans are roughly 50 percent higher than Medicaid -- $9,000 compared to $6,000 on average -– Roy said Arkansas could take money away from other states.

Jeb Bush' Hispanic Leadership Network to powwow in Coral Gables

From a press release:

WASHINGTON, DC – Building upon a pro-immigration reform advertising campaign launched last Sunday, the Hispanic Leadership Network (HLN) today announced its third annual Miami Conference to be held April 18-19 at the Biltmore Hotel in Miami, Florida. Under the theme “Family Reunión,” the conference will be chaired by former Florida Governor Jeb Bush and former U.S. Secretary of Commerce Carlos Gutiérrez.

“HLN continues to successfully expand its role as a platform for elected officials, business leaders, and community activists to engage with Hispanics in a productive dialogue about the most pressing issues facing our country. I am incredibly proud of what HLN has already accomplished and enthusiastic about what lies ahead,” said former Governor Jeb Bush.

'Anti-Sharia' law is back

A renewed attempt to pass a controversial "foreign law" bill proposed by Sen. Alan Hays, R-Umatilla, and Rep. Larry Metz, R-Yahala, was approved by the Senate Judiciary Committee Wednesday, after more than an hour of sometimes emotional public testimony.

The bill, SB 58, bans courts or other legal authorities from using religious or foreign law as a part of a legal decision or contract relating to family law. Florida law would supercede foreign law regarding divorce, alimony, the division of marital assets, child support and child custody. The bill is ready to be heard on the House floor but it has more committee stops in the Senate. Last year, the bill passed the House but died in the Senate.

Supporters say the proposal isn’t targeting religious groups, but the bill has been criticized as anti-Sharia, a Koran-based code followed in some Islamic countries, by Islamic groups as well as Jewish organizations and the American Civil Liberties Union.

"It should raise some eyebrows for you, the fact that there’s a rabbi speaking out against the bill who’s from Israel and a Arab Muslim, that’s me, also speaking out against the bill," said Ahmed Bedier, president of the United Voices for America. "We may disagree what is happening in the Middle East, but we agree on this bill — that it discriminates and targets our communities."

Hays said the bill "prevents a potential problem" from occurring in Florida courts and that it’s "not insulting to any religious group."
"If your law violates the constitutional rights of a Floridian, it has no business being in a Florida court," Hays said.

Rochelle Koff, Times/Herald Tallahassee Bureau

Rick Scott message guru guiding Miami Dolphins stadium strategy

@MarcACaputo

Give it to the Miami Dolphins: They know how to play offense.

At least in the state Capitol.

In the club's effort to get a tax-subsidized stadium deal, it hired top Republican message-master Curt Anderson, who was part of the consultant dream team that helped Rick Scott, an unknown former hospital executive with a blemished past, become governor of Florida.

Now Anderson might be embarking on a just-as-tough effort: Getting a jaundiced Miami-Dade electorate to approve a tax deal for a stadium. A new poll from FIU pollster Dario Moreno shows it's a longshot. Voters here are still stewing over the Miami Marlins stadium deal.

A poll from Anderson's firm, OnMessage Media (an arm of OnMessage Sports, which has worked on other tax-sports issues), indicates voters can be persuaded in Miami-Dade to back the stadium deal. (Moreno poll is here; Anderson poll nugget is here).

Of course, all of this is on paper. If, and it's a big if, this passes the Legislature, Scott will have to decide whether to sign the bill. Although, Scott just so happened to voice a measure of support for the stadium deal today.

If all that happens, then the campaign begins to persuade people in earnest. As Prussian Gen. Helmuth von Moltke said: No battle plan survives first contact with the enemy. Boxer Mike Tyson's version: Everyone has a plan until they get punched in the mouth.

Here's Anderson's slogan: "We measure public opinion. Then we change it."

But not always. For every Rick Scott gubernatorial success story, there's a Texas Gov. Rick Perry campaign for president, which Anderson, Fabrizio and Warfield all worked on (Dolphins owner Steven Ross, incidentally, had backed Mitt Romney).

Gov. Rick Scott tells House he's not a fan of exploding campaign finance cap

In another sign that Florida Gov. Rick Scott is moving to the populist middle, the govenor's aides told Florida House leaders Wednesday that he cannot support their plan to raise campaign contribution caps from $500 to $10,000 in exchange for more rigorous disclosure.

"What we’ve told the House is that when they do that they reduce the importance of the individual who can only write a $500 check so I think they ought to really look at that a lot more closely,'' Scott said Wednesday in an interview with the Herald/Times. "I want to see what they come back with but we’ve got to try to keep as many people involved in the process as we can.''

Scott, who spent more than $73 million of his own money to get elected, has collected dozens of five and six digit contributions through his political committee, Let's Get to Work. Three of the contributions in the last year were for $250,000 -- from Florida Power & Light, resort casino magnate Sheldon Adelson and AutoNation Founder Wayne Huizenga.  

The House is moving a top priority bill of House Speaker Will Weatherford, R-Wesley Chapel, that would eliminate the political slush funds known as Committees of Continuous Existence, raise the campaign finance cap to $10,000 from the current $500 per campaign, and require accelerated disclosure of all campaign finance contributions.

Weatherford's dad was right: Medicaid paid the bills

A day after voicing opposition to expanding Medicaid in his inaugural speech of the 2013 session, Florida House Speaker Will Weatherford issued a statement clarifying a confusing, but crucial, part of the speech.

Weatherford told House members on Tuesday that he opposed the expansion because it crossed the line of “proper government.” He shared an emotional story about his brother Peter, who died at 20-months in 1995 when he was 15.

His medical care was too expensive for his family to afford, but a “safety net” helped out, he said.

Weatherford, however, didn’t describe what that safety net was. When reached by the Times/Herald after the speech, Weatherford’s father said Medicaid paid more than $100,000 in costs.

Asked by reporters on Tuesday if Medicaid paid the bills, Weatherford said that it had not. When told that his father had said they were covered by Medicaid, Weatherford said he would learn more.

A day later, Weatherford said his research showed that medical care was paid for by the Medically Needy Program, which does get paid for with Medicaid dollars.

House higher ed panel pushes along in-state tuition, preeminence bills

2013 may finally be the year for the college-bound children of undocumented immigrants.

On Wednesday, the House higher education panel approved a bill granting in-state tuition to teenagers who are U.S. citizens, but whose parents are undocumented. Historically, those students have had to pay out-of-state rates to attend Florida’s colleges, universities and technical schools, even if they were born and raised in the Sunshine State.

The bill has been killed over and over again. But this year, it has newfound legs. House Speaker Will Weatherford expressed support for the idea this week, and lawmakers from both political parties are pushing similar proposals in the Senate.

Read the full story here.

The higher education panel also gave a nod to a controversial proposal that would allow one state university to be named Florida’s preeminent research institution. The criteria for making such a judgement? Student performance, retention rates, research spending, national rankings and endowment, among other factors. 

Atwater: Medicaid expansion probably won’t pass now, but may be ‘inevitable’ later

Speaking to the Florida Chamber of Commerce on Wednesday, Florida’s Chief Financial Officer Jeff Atwater expressed many of the same concerns of other Cabinet members about Gov. Rick Scott’s proposal to accept federal funding and expand Medicaid: It would grow a government entitlement and be a new billion-dollar expense for the state.

But Atwater seemed to agree with other experts and commentators who believe that Florida and other states will eventually agree to some form of Medicaid expansion, and the billions of federal dollars it will bring. 

Atwater said that the state was in a “really tough spot” because expanding Medicaid will bring additional costs, but not accepting the federal money could have tough consequences as well. Florida’s safety net hospitals will see much of their federal funding evaporate under the Affordable Care Act, and the expansion of Medicaid was supposed to pick up the slack.  The state’s Low Income Pool (LIP) could also face new financial “stresses,” making it difficult for Florida's health care system, said Atwater.

“They may delay this—a ‘No’ is not a ‘No’ forever,” he said. “They can join anytime… I believe they’re going to pass [on the expansion]—that’s my take," he said. "And then I think, as the stresses begin to fall like, again, LIP being diminished, this is going to cause great stress to that choice. And, I don’t know, the inevitable, it may be, no matter what people think, happens.”

Atwater said that he believes the best option is for Florida and the federal government to come up with a more acceptable alternative. A spokesperson for the CFO's office said that Atwater remains opposed to Medicaid expansion.

Miami Dolphins chief trashes "ginned up" poll showing stadium plan is highly unpopular, toxic

@MarcACaputo

A written statement from Miami Dolphins President and CEO Mike Dee on today's poll showing about 73 percent of likely Miami-Dade voters don't like the club's tax-subsidy plan:

“A ginned-up poll paid for by a mystery client that goes out of its way to lead people to a negative position is hardly enough to sway us from our efforts to put this issue in front of voters this spring. We believe in the people of Miami Dade County, and trust that the voters can and will see the differences in our project from prior ones.

“The fact that the Dolphins will pay a majority of the costs, and that the rest will be paid by tourists and patrons of the stadium - and never by residents of Miami Dade - along with creating thousands of jobs and millions in economic activity for the people of our community, are powerful facts than this cynical, politically-motivated poll conveniently ignores.

“We know that we have to make our case to the elected leaders and the people of Miami Dade. It’s a challenge we readily accept and are confident it will end with the voters approving our plans to create more jobs and more opportunity for the people of Miami Dade County."

One note: There's no evidence that this was a so-called "push poll" that, in Dee's words, "goes out of its way to lead people to a negative position." Indeed, it described one of the sales-tax breaks the Dolphins seek as a "rebate" when the state program can act like a subsidy.

Here's the question pollster Dario Moreno said he asked:

The Dolphins are asking for a one-cent increase in the "bed tax" in Miami-Dade County, as well as a $3-million-a-year rebate in sales tax revenue generated by goods and services at Sun Life Stadium. Stephen Ross, the owner of the Dolphins, has pledged to pay for at least half of the $400 million renovations himself, meaning the team is asking for approximately $199 million in public funding. Do you support or oppose this plan?

And there's an irony as well: The Dolphins shared a portion of their own poll, but it was more of a push poll that Moreno's. That is, it message-tested, which all campaigns have to do, by asking a series of questions of voters to figure out how popular an item is or how to make it popular. The survey, conducted by a group called OnMessage Sports, that they said showed 59 percent approved of the plan and only 33 percent disapproved after they were "informed." The poll's crosstabs were not shared with The Miami Herald, unlike Moreno's survey.

Gov. Scott puts conditions on Dolphins' tax break

As lobbyists for the Miami Dolphins seek legislative approval for a tax break for improvements to Sun Life Stadium, Gov. Rick Scott is weighing in and proposing additional hurdles to any stadium deal.

A document obtained by the Herald/Times lists a series of conditions -- called "principles" by Scott advisers -- that would have to be met before the Dolphins can secure a rebate of $90 million in sales taxes over 30 years.

Among the conditions:

* Dolphins owner Stephen Ross would have to match the cost of stadium improvements, and "the more the better."

* Miami-Dade would have to provide a local funding match, and "the more the better."

* The team would have to commit to staying at the stadium for the life of the tax break (which could be 20 or 30 years), or else the team would be required to repay bond payments and be responsible for future bond payments.

* The Dolphins must pay for an economic impact study, "vetted and approved by Enterprise Florida," that shows a return on investment.

* Any tax breaks would have to approved by voters in a county-wide referendum.

The referendum requirement was added to the bill (SB 306) that unanimously passed the Senate Finance & Tax Committee Wednesday, and Dolphin lobbyist Ron Book said the economic impact study is already underway.   

-- Steve Bousquet