Florida House leaders clash on Medicaid expansion

Democratic House Minority Leader Kionne McGhee at AP pre-Legislative session
Democratic House Minority Leader Kionne McGhee at AP pre-Legislative session
House Speaker Jose Oliva (Wikipedia)
House Speaker Jose Oliva (Wikipedia)

If there’s one thing you need to know about House Speaker Jose Oliva, it’s that he believes that most of the answers to make Florida a better place to live come from the free market, and not from government.  

So it was hardly a revelation when he told reporters who gathered at the Associated Press’ pre-legislative session briefing in the Capitol on Wednesday that he has absolutely no interest in reviving talk of expanding Medicaid in 2019.  

“Medicaid expansion is the worst of all band-aids,” the Miami Republican declared. “We’re going to take a form of healthcare that most doctors don’t accept. That reduces the quality the more people you pile onto it. And we’re going to find that as a solution to access to healthcare?” 

Oliva’s view on expanding Medicaid – that it’s an inefficient delivery system for providing care – is a theme that Florida House Republicans have been echoing for nearly a decade in explaining why they don’t support the concept, and it’s the main reason why Florida remains one of just 14 states in the country that hasn’t expanded Medicaid since the Affordable Care Act was passed in 2010. 

The law called for the federal government to pick up 100 percent of the costs to the states for newly eligible people to go on Medicaid. That will phase down to 90 percent in 2020.  More states are agreeing to join in the program this year, with Virginia starting in January and Idaho, Nebraska and Utah following later this year.

Oliva said he wants everyone in Florida to have access to health care, but says that won’t happen until the environment is adjusted to allow for free-flowing competition. “We have to bring in some real market forces into it, so that people have to compete for that business,” he said. 

About an hour later, Democratic House Minority Leader Kionne McGhee offered a very different take on letting “free-market” principles take the lead on health care reform.  

“I am here to say that Medicaid expansion works. But unfortunately we’ve seen a legislature that simply said no,” he said. “It’s not a policy disagreement. It’s an ideological tantrum.” 

McGhee, who, like Oliva lives in Miami, added that what the state has been doing for the past two decades in trying to provide more access for health care simply isn’t working. 

Florida Medicaid covers 4.2 million low-income children, pregnant women, adults, seniors and people with disabilities. More than 1.3 million  additional people would be covered if Florida were to expand Medicaid, according to healthinsurance.org. 





Mitch Perry
Mitch Perry has spent the past 18 years covering news and politics in the Sunshine State, most recently with FloridaPolitics.com. He worked for five years as the political editor of Creative Loafing in Tampa, and before that he was the assistant news director at WMNF radio, where he served as creator/anchor/producer of the hour-long WMNF Evening News. A San Francisco native, Mitch began his career at KPFA Radio in Berkeley in the 1990's.


  1. A healthy public is a benefit to the economy.

    Healthcare is too expensive, esp since medication costs have been markedly increased unrealistically , unfairly!

    Medicaid expansion helps the economy.

    (Pres. Reagan and others have likewise dumped the healthcare and other facets of society onto “unleashing the market”.

    Markets are profit-led, not public health-led, as all know.

    Markets need tighter oversight and the Public needs Medicaid expansion, just like the other wise states have.


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