The pair of separate reports lands in the middle of campaign season as Gov. Rick Scott, a former hospital executive, is running for U.S. Senate and has been on the defensive over his long health care record. | AP Photo With Scott on defense, reports show Florida woes for not expanding Medicaid

TALLAHASSEE — Two new reports that highlight Florida’s decision to not expand Medicaid found it left the state with more women at risk for mental health problems and significantly increased the number of uninsured overall across the state.

The pair of separate reports lands in the middle of campaign season as Gov. Rick Scott, a former hospital executive, is running for U.S. Senate and has been on the defensive over his long health care record.


The Centers for Disease Control and Prevention reported that Florida has the third-highest percentage of uninsured adults in the country: 20.1 percent in 2017. That’s up from 19.8 percent in 2016. The average percentage of uninsured adults in non-expansion states was 19 percent in 2017, more than double the average uninsured percentage in expansion states: 9.1 percent. And while non-expansion states’ uninsured percentages are ticking up, expansion states’ uninsured percentages are continuing to decline.

The other report, by the Institute for Women’s Policy Research, focused on Florida and found that women’s mental health is declining while their suicide rates are going up. The Washington, D.C.-based tax-exempt policy group, which works with American University, is rated as one of the “least biased” organizations.

“The rate of Florida women’s mortality due to suicide increased from 5.5 per 100,000 women of all ages in 2001 to 6.5 per 100,000 women in 2015,” the report states. “The average number of days per month that women in Florida reported poor mental health also increased, from 3.7 days in 2000 to 4.5 days in 2015.”

The organization’s senior researcher, Julie Anderson, told POLITICO via email that Florida’s high number of uninsured women — due in large part to the state’s decision to not expand Medicaid — is likely a “contributing factor” to their increasing mental health issues.

“If those without health insurance are only seeking help for acute issues, at places like an urgent care center or ED [emergency department], they are unlikely to get help for mental health concerns unless they are in a psychiatric crisis,” Anderson wrote.

Anderson said people with insurance have a primary care doctor who can prescribe medications or refer them to mental health professionals, while those without insurance or primary care doctors are more likely to have their mental health problems go undiagnosed and untreated.

Scott spokesman McKinley Lewis blamed Congress for the woeful figures.

“While Florida’s Medicaid program is operating at the highest quality level in its history, Congress hasn’t controlled the nation’s health care costs or passed a balanced budget in nearly twenty years,” Lewis said. “It’s also important to note that Medicaid expansion was related to able bodied, working adults — not pregnant women or children who are already eligible for services.”

Scott, an on-again, off-again opponent of Medicaid expansion, ran against former President Barack Obama’s landmark law, the Affordable Care Act, but Florida’s uninsured rates dropped overall because of it. The new statistics show Florida is worse off for not expanding Medicaid and insuring its roughly 600,000 working poor.

Since announcing his U.S. Senate bid last month to challenge Democratic incumbent Bill Nelson, Scott and his administration have been aggressively defending the governor as opponents batter away on his health record.

On Tuesday, during a Senate floor speech, Nelson bashed the Republican-controlled Legislature and Scott’s administration for not expanding Medicaid, calling it “shortsighted.”

“There's almost $5 billion a year that is sitting on the shelf,” Nelson said. “That is Florida taxpayer money that is going elsewhere.”

Medicaid is a state-federal program, but the feds pay the bulk of it.

Nelson also implicitly attacked Scott for trying to cut health care payments to Florida’s poorest patients covered by Medicaid by eliminating what is known as “retroactive eligibility.”

If approved, the state’s Agency for Health Care Administration, or AHCA, will no longer pay 90 days' worth of health care bills patients might have accrued just before they enrolled in Medicaid. The move has been widely criticized by health providers and Florida Democrats as a knock to poor patients and the hospitals that treat them regardless of whether they have insurance. As a new policy, its impact on patients remains unknown.

Scott’s office has defended the move, saying it’s merely administrative, “about paperwork, not patient care.”

Scott’s health care agency has also pushed back on criticism, saying it has to try and cut those payments under direction from the Republican-controlled Legislature.

The agency had previously sought approval for the measure from the federal government and included the cuts in its annual budget exercise as a way to save $98 million without cutting services in an area with a lot of fixed cuts, but Scott didn’t include the cuts in his proposed budget. The final measure was included in the budget agreement passed during the legislative session that ended March 9, which Scott did not veto.

On top of Medicaid, Scott is dealing with an ongoing lawsuit with a Broward County nursing home under criminal investigation for the deaths of 12 elderly residents during Hurricane Irma. Scott’s administration revoked the nursing home’s license after the residents’ deaths were declared homicides by local police. The nursing home says Scott helped contribute to statewide systemic failures when he gave out his personal cellphone number before the storm. The issue has come under federal scrutiny.

Scott’s also gotten an unfavorable federal audit that found his health care agency does not ensure nursing homes correct deficiencies 19 percent of the time. AHCA has pushed back on that finding as well and has even written the federal agency that conducted the audit requesting it change the title of its report — “Florida Did Not Always Verify Correction of Deficiencies Identified during Surveys of Nursing Homes Participating in Medicare and Medicaid” — but the federal office declined.

All these problems are piled on another stinging vulnerability for Scott: his own past. He’s a former hospital chain executive who resigned right before his company was charged with what was then the largest health care fraud in U.S. history.

Democrats want Florida voters to remember Scott’s corporate past.

When Scott last month announced he was challenging Nelson, the Democratic Senate Majority PAC released a video called "Won't Look Out For You" that mentioned the fraud that plagued Columbia/HCA. It’s only gotten about 1,700 views.