Key Point: “DeSantis could do something about this. He has refused. In fact, as of this moment, his administration is embarking on a plan that some analysts worry could make the problem worse.”

HuffPost: While Ron DeSantis Is Fighting Culture Wars, Millions Of Floridians Are Losing Their Health Care
By Jonathan Cohn

• Florida Gov. Ron DeSantis keeps making news with his self-described campaign to fight “woke” ideology. The latest headlines came about two weeks ago, when the Republican announced that he was prohibiting public high schools from offering a new Advanced Placement course in African American history. The course, his administration explained, “lacks significant educational value.”
   
• But DeSantis has some other governing responsibilities, too. One of them is looking out for the health and economic well-being of Florida residents, including those who can’t pay for medical care on their own because they don’t have insurance.
   
• Florida has quite a lot of them ― nearly 2.6 million as of 2021, according to the most recent U.S. census figures. That’s about 12% of its population, which is well above the national average of 8.6%. It’s also more than all but four other states.
   
• Floridians without insurance suffer because when they can’t pay for their medical care, they end up in debt or go without needed treatment or both. The state suffers, too, because it ends up with a sicker, less productive workforce as well as a higher charity care load for its hospitals, clinics and other pieces of the medical safety net.
   
• DeSantis could do something about this. He has refused. In fact, as of this moment, his administration is embarking on a plan that some analysts worry could make the problem worse.
   
• The simple, straightforward reason so many Floridians have no health insurance is that its elected officials won’t sign on to the Affordable Care Act’s Medicaid expansion, which offers states extra federal matching funds if they make the program available to everybody with incomes below or just above the poverty line.
   
• Most states have now done just that. It’s the single biggest reason that the uninsured rate nationwide is at a record low. But eleven states have held out, leaving in place the much more limited eligibility standards they had established before the Affordable Care Act took effect.
   
• Florida is one of them. Childless adults in the Sunshine State can’t get Medicaid unless they fall into a special eligibility category, like having a disability. And even adults with kids have a hard time getting onto the program because the standard income guidelines are so low ― about 30% of the poverty line, which last year worked out to less than $7,000 for a family of three. That’s not enough to cover rent, food and other essentials, let alone buy a health insurance policy.
   
• The non-expansion states all have Republican governors or legislatures or both, and are nearly all in the Deep South. They represent the last line of resistance against Obamacare, which Republicans have spent more than a decade fighting and, famously, came very close to repealing in 2017.
   
• DeSantis was no mere bystander to that effort. As a Republican serving in the U.S. House, he was part of a far-right caucus that voted against the first ACA repeal bill that leadership brought to the floor because, DeSantis and his allies said, it didn’t undo enough of the law’s protections for people with pre-existing conditions.
   
• GOP leaders eventually put forward a more aggressive repeal. DeSantis and his colleagues voted yes on that one, but it failed in the Senate.
   
• Florida just announced its plan and, according to Joan Alker, executive director of Georgetown University’s Center for Children and Families, the state seems intent on pushing ahead quickly even though its own projections suggest 1.75 million Floridians could lose insurance as a result.
   
• “They’re very anxious to get almost 2 million people off of Medicaid, which is scary,” Alker told HuffPost. She added that she is especially worried about children, who represent a disproportionate number of Florida’s Medicaid population because the income guidelines for young people are looser than they are for adults.