The two main Republican candidates battling for Florida governor have a simple message when it comes to health care: Just say no to Obamacare.
Agriculture Commissioner Adam Putnam and U.S. Rep. Ron DeSantis have been highly critical of the Affordable Care Act and have vowed to oppose any effort to use the federal law to expand Medicaid to cover uninsured Floridians.
The Republican-controlled Legislature has twice in recent years debated, but ultimately rejected, proposals to expand coverage to an estimated 700,000 Floridians, and incoming House Speaker Jose Oliva, R-Miami Lakes, remains opposed to an expansion.
鈥淚鈥檓 glad that Florida made the right decision for our kids and our grandkids by not swallowing what Obamacare was trying to push down Florida鈥檚 throat,鈥欌�� Putnam said during a debate last week.
While Medicaid --- the main health care safety-net program for poor people --- commands a huge share of the state budget, the Republican candidates have not provided in-depth details about what they would do with the program if elected. And despite criticism of Obamacare, their election websites do not mention health care or if they would take actions to expand health coverage.
Putnam, who during the debate said that 鈥渉ealth care is not a right,鈥� said the state should make sure that it 鈥渙ught to be patient-centered,鈥� as well as 鈥渕arket-driven鈥� and 鈥渢ransparent.鈥�
He added that he would be in favor of adding a work requirement for any able-bodied person seeking public assistance.
DeSantis has echoed Putnam鈥檚 comments.
鈥淚鈥檓 going to seek a waiver from Obamacare so we can actually have patient-centered, market-based insurance and protect people with pre-existing conditions,鈥� DeSantis said. 鈥淲e can do it, but we鈥檝e got to be reform-minded.鈥�
DeSantis, who has been endorsed by Oliva, also said he would support efforts to claw back money from Florida hospitals that treat Medicaid patients. Taking a page from current Gov. Rick Scott, DeSantis said hospitals were responsible for 鈥渙utrageous charges.鈥�
The positions on Medicaid expansion put Putnam and DeSantis in stark contrast to the five Democratic gubernatorial candidates, who have made expansion a part of their platforms. Moreover, Democrats have called health care a right.
Alan Levine, who was a top health-care official in Florida under former Gov. Jeb Bush, said voters should not assume that the two Republicans wouldn鈥檛 prioritize health care because they are unwilling to declare it a right.
He noted that both have supported health-care proposals while they served in Congress. Putnam was in Congress before getting elected agriculture commissioner in 2010, while DeSantis is finishing his third term in Washington.
鈥淭he fundamental issue boils down to a deep mistrust of the structure of Medicaid, the federal nature of it, and a concern about a shift from private market-based approaches to coverage toward what looks to many as a movement toward more federal control of health care,鈥欌�� Levine said. 鈥淚n a Republican primary, that鈥檚 a safe position for Republican candidates to take ...
鈥淭he obvious challenge is that most people do believe that when someone is sick, it is compassionate to make sure they get the care they need,鈥欌�� Levine added. 鈥淚n a general election, the candidates need to clarify about how they view this issue.鈥�
More than 1.7 million Florida residents enrolled in a federal insurance exchange, created under the Affordable Care Act, to buy health policies this year. Ninety percent of them are receiving some sort of discounts to help offset the costs of the coverage, according to federal data.
Former Florida Insurance Commissioner Kevin McCarty said health insurance is a critical issue for families because it 鈥減lays into the everyday pocketbooks of Floridians鈥� and families across the country.
McCarty, who was insurance commissioner for 13 years and worked for three different Republican governors, said he anticipated the health insurance market to deteriorate now that the 鈥渋ndividual mandate鈥� to purchase health insurance is being eliminated.
McCarty, a Republican, said that without a mandate, healthier people won鈥檛 buy insurance, leaving only the sicker people to purchase Obamacare plans in the federal exchange. That, he told The News Service of Florida, 鈥渃ould potentially collapse the system.鈥�
鈥淚t鈥檚 absolutely going to come to a head,鈥� McCarty said.
Meanwhile, despite the limited focus on health care by the two Republican candidates, each of them has picked up support from parts of the industry.
DeSantis recently won the backing of the Florida Medical Association, the powerful group that represents 22,000 doctors in the state.
鈥淭he FMA PAC is proud to be the first statewide association to endorse Congressman Ron DeSantis as Florida鈥檚 next governor,鈥� FMA Political Action Committee President Mike Patete said in a statement. 鈥淲e believe he is a true friend of medicine 鈥�.鈥�
While DeSantis may have the FMA鈥檚 endorsement, Putnam, to date, has received the most money from the health-care industry, according to an analysis of contribution data that includes occupation listings.
Putnam has received more than $1 million from contributors involved in the industry. DeSantis has taken in roughly $700,000, which includes a $250,000 check from physician Miriam Adelson, the wife of gambling magnate Sheldon Adelson.
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