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possibly the overall health budget as well for the state (Kaiser Family Foundation, 2020). "On January 14, 2020, Democratic legislators introduced bills in both the state House and Senate to put a constitutional amendment expanding Medicaid to a statewide vote. Still, these are likely to fail in the Republican-controlled legislature" (Kaiser Family Foundation, 2020, para 10). Can Florida afford to expand Medicaid coverage to all citizens without posing significant losses in other areas of need within the state? At what cost and who will be the portion of the
MEDICAID EXPANSION AND DUAL ELIGIBILITY 5population that covers the added financial burden in Florida? Currently, the percent of the peoplein the state that is for expanding coverages to other categories lies between 50-68% (Norris, 2018). The congressional leaders Florida have a very challenging and daunting task ahead to not only balance the budget but incorporate the additional 1-2 billion dollars into the state's annual budget projections. It is reported that Florida should agree to expand Medicaid coverage to the population at 138% of the poverty level. The expansion could cost Florida taxpayers an estimated 1 billion dollars per year in added taxes (Gross, 2020). In 2018, Norris reported that the number of Floridan's receiving Medicaid coverages such as CHIP was 4,229,664, and 4.2 million residents on Medicaid. Portions of the population within the state that are most vulnerable account for 72% of the fiscal budget and statistics for coverages within the state. Dual eligibility provides for residents most at risk for significate health conditions and includes coverage under both Medicare and Medicaid (Roberts, Mellor, McInerney, & Sabik, 2019). Dual eligible citizens are afforded coverages under Medicare but also have access to Medicaid benefits that pay a portion of the person's medical expenses. Dual eligibility provides for those on Medicare parts A & B, to be able to maintain their primary care physician, but seek services without penalty or having to switch due to healthcare coverage shortages. Libersky, Hedley, & Verghese (2013) "as states introduce new or expand existing managed care programs for duals, it will be important to understand the distinct enrollment and cost trends for duals under age 65 across the range of managed care arrangements in which they participate" (p.1). Residents within the state of Florida and in other states engaging in dual eligibility programs through Medicare and Medicaid are more apt to seek healthcare services even if they cannot afford the price. Dual eligibility provides a more affordable option for low-income
MEDICAID EXPANSION AND DUAL ELIGIBILITY 6seniors to access specialty services that they might otherwise not be provided. Medicare is a federally funded program affords for states engaging in dual eligibility programs to reach into Medicaid dollars to cover portions of healthcare services that the person might otherwise have t pay out of pocket to receive. Those most at risk or facing more significant barriers in obtaining needed services are better equipped.