Reflecting the same fault lines that have emerged nationally, Florida’s Democratic and Republican candidates for governor are deeply split over whether the state should take a more direct role in providing health care.
And that split is resonating in a campaign where health care has become one of the touchstone issues for the five Democrats running in the Aug. 28 primary.
Democrats Andrew Gillum, Gwen Graham, Jeff Greene, Chris King and Philip Levine are united in their support for expanding Medicaid to the 700,000 Floridians who would qualify for the program if Gov. Rick Scott and the Republican-dominated Legislature had agreed to expand coverage to uninsured working adults.
But the five Democrats have not taken identical stances on health-care issues, including whether the state should allow the recreational use of marijuana instead of just limiting it to patients with chronic medical conditions.
And none of the Democratic candidates appears to have cornered support from Florida’s vast health-care industry. An analysis of contribution data to campaigns and political committees shows Levine, a former Miami Beach mayor, has collected more than $210,444 from the industry, while King, a Winter Park businessman, has gotten nearly $181,000. Graham a former congresswoman, has received nearly $171,000, and Gillum, the Tallahassee mayor, reported taking in contributions of nearly $160,000. Greene, a Palm Beach billionaire, has virtually self-funded his campaign.
Democrats are making sure voters are aware of health-care issues during the campaign. Florida’s uninsured rate in 2013, the year before federal Affordable Care Act plans became available, was 20 percent and one of the highest in the nation. In 2016, the rate was 12.5 percent.
The Florida Democratic Party has pointed to polls, such as one done this year by AARP and Politico, that showed health care is a top issue among voters 50 and older.
But Kevin McCarty, the state’s former long-time insurance commissioner, said he doesn’t think it will be a marquee issue this election.
A Republican, McCarty said that as Floridians prepare to go to the polls in coming weeks a mandate that insurance companies sell policies to people regardless of pre-existing conditions remains in effect. Also remaining in effect are subsidies that flow to people who are purchasing policies on the federal health-care exchange. The subsidies, McCarty said, keep people protected from having to pay the full costs of the policies.
“I don’t think it’s front and center of the mind,” McCarty said.
“But I don’t think there’s any question those issues will be front and center of the political arena for the next four years,” McCarty said, referring to, among other things, a multi-state legal challenge to the Affordable Care Act filed in federal court in Texas.
U.S. Attorney General Jeff Sessions has said he won’t defend the law against the challenge, which Florida Attorney General Pam Bondi joined. The challenge could ensure that the pre-existing condition protections will be eliminated. Seventeen other states have intervened to defend the Affordable Care Act.
More than 1.7 million Florida residents enrolled in the federal exchange 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.
King and Graham said they aren’t afraid to use the power of the governor’s office to bolster the insurance exchange.
Both candidates’ platforms would require managed-care plans participating in Medicaid to offer health plans on the federal exchange. King said he also would use incentives --- carrots and sticks --- to require Medicare health plans to participate in the marketplace. He called the policy “universal participation.”
Gillum supports the Affordable Care Act and has said that he would change Florida’s insurance laws to make sure they have the same pre-existing condition protections that are in the federal law.
But Gillum also said he also supports U.S. Sen. Bernie Sanders’ “Medicare for All” plan. Sanders, a Vermont independent who unsuccessfully sought the Democratic presidential nomination in 2016, has endorsed Gillum’s campaign.
While McCarty maintains that health care isn’t foremost on people’s minds this year, residents have enough concerns to keep the advocacy group Florida Voices for Health busy, said Louisa McQueeney, the group’s communications director.
She said the organization has been hosting town-hall meetings and talking with people who could be impacted if protections in the federal law are eliminated.
People who come to Florida Voices for Health for assistance, though, generally aren’t pressing for information about the gubernatorial candidates and the candidates’ health-care and insurance agendas.
“They want information on health care,” she said. “What we’re being asked for is to help us to understand the potential changes to the Affordable Care Act, the Medicaid expansion and now, the short-term plans.”
The Democratic candidates part ways when it comes to other health-care issues that may resonate with voters, including their positions on whether to expand marijuana legalization in Florida beyond current medical-only uses.
Gillum was the first to support allowing recreational use of the drug. King and Levine also support it.
Graham and Greene support legal marijuana only for medical uses. Graham said, though, that she would decriminalize the use of marijuana, a step short of full legalization.
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