Florida Is Trying To Attract Foreign Patients Instead Of Extending Insurance To Its Own Residents

CREDIT: AP Photo/Phil Sears

Renee Walker, from Orlando, holds a sign criticizing Florida's decision not to expand Medicad during the kickoff for "Moral Monday" on March 3, 2014 in the state's Capitol Courtyard

Florida lawmakers may vote to spend millions of dollars to encourage sick people to use local health care services — just not the hundreds of thousands of poor and uninsured people who actually live in the Sunshine State.

The Florida state Senate’s Commerce and Tourism committee unanimously backed a bill on Tuesday that would appropriate $5 million in 2015 for attracting medical tourism — a burgeoning industry in which people travel to other countries to seek health care that is either too expensive or too difficult to access in their own. If the full legislature passes the funding, Florida’s tourism arm will direct a marketing campaign that plays up the state’s health care providers and specialty medical services to an international audience.

Medical tourism usually brings to mind the hundreds of thousands of Americans — both insured and uninsured — who go to other countries such as Costa Rica, Mexico, India, Thailand, and Brazil to seek treatment because medical care in the United States can be prohibitively expensive. But according to Patients Beyond Borders, between 600,000 and 800,000 foreign patients came to the U.S. for health services in 2013 despite the relatively high costs of care here. These patients are often from countries that have yet to develop certain advanced procedures or technologies, or where those procedures are still far too costly. For instance, many international consumers visit well-known clinics such as the Cleveland Clinic in Ohio, Johns Hopkins in Maryland, and the Mayo Clinic arms in Arizona, Minnesota, and Florida for cancer care and dental, orthopedic, and cosmetic surgery.

Those are all still pretty expensive and lucrative specialized procedures that attract patients who can afford them (on top of an international trip to the United States). So it’s not surprising that the Mayo Clinic Hospital in Jacksonville, Florida is a big supporter of the bill, which was proposed by state Senate Health Policy Committee Chair Aaron Bean (R). “Florida can and should be a top-tier health care destination,” said Bean of his legislation.

But while Bean and his fellow lawmakers think it’s worth spending millions in state dollars catering to a relatively wealthy international crowd’s health care needs, they’re much less inclined to take approximately $51 billion from the federal government to expand Medicaid under Obamacare and provide basic health benefits to about 850,000 poor people who are actually living in the state today.

Florida has the second-highest uninsurance rate in the entire country. Very few adults qualify for Medicaid under the state’s current rules, which only makes the program available to parents with dependent children who make just a third of the poverty level. Gov. Rick Scott (R-FL) stunned many political observers by embracing the Medicaid expansion in early 2013. “While the federal government is committed to paying 100 percent of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care,” said Scott at the time.

But Florida lawmakers have repeatedly failed to pass Medicaid expansion, and Scott began dodging questions on whether he still supports the provision after he filed for re-election. Most recently, reports have surfaced that Bean — the medical tourism bill’s main sponsor — may block a GOP proposal to accept billions in Medicaid expansion dollars. Bean prefers “a state-based, highly limited insurance exchange that… technically cannot be called an ‘insurance exchange’ because the products are so limited they do not meet the legal definition of insurance,” according Florida health reform advocate Gary Stein.

The Scott administration is currently facing fines by the federal government for imposing an illegal cap on the number of times that Florida’s Medicaid beneficiaries can visit the emergency room annually.