Gov. Scott’s Choice: Education Versus Health Care?

John O'Connor / StateImpact Florida

Gracie Fowler dropping her son, Jackson, and daughter, Havilah, off at karate lessons. She wants Florida to expand access to Medicaid under the Affordable Care Act to ensure coverage for her kids and herself, but doesn't think it should come at the expense of schools.

Gracie Fowler earns $11 an hour at an Orlando title company. It’s just enough that sometimes she earns too much for her two kids to qualify for Medicaid.

That’s what happened for two months earlier this year.

“Luckily they didn’t get sick but that was like the only couple of months where they didn’t have a little ear infection or they didn’t need to be tested for strep,” she says. “If they would have needed to go to the doctor then it would have been an emergency room visit. ”

Fowler, 35, recently got insurance through her job. But she’s worried she or her children, Jackson, 8, and Havilah, 6, could lose health coverage again. Sometimes it depends on whether Jackson and Havilah’s father pays child support.

And if Florida expands Medicaid to cover more adults, she’d be eligible — and that could save her $120 a month.

“That’s heavy-duty to me. My phone bill is $50,” she says, one of many tough budget choices she makes in her household. “I’m scared. I’m a single mom. This rides on me. These children are with me 99 percent of the time.”

But Gov. Rick Scott is worried about a heavy-duty bill for expanding Medicaid.

Doing that could cost state taxpayers $1.2 billion dollars by 2020, according to a Kaiser Family Foundation analysis. The expansion would increase the state portion of the Medicaid budget by 3.8 percent.

Education comprises nearly twice as much of Florida general revenue spending as Medicaid, though Medicaid is growing faster. Combined, education and Medicaid account for more than half of state general revenue spending as the state has cut other programs during the Great Recession.

The federal law’s expansion would add 951,000 low-income adults to the state’s Medicaid rolls, according to the Kaiser Family Foundation, about two-thirds of whom have no insurance.

But Scott says the money is better spent on education. He’s says Florida will not expand Medicaid under the federal health care law.

“Right now you have a choice in Florida government,” Scott said in a Fox News Channel interview last week. “It’s Medicaid, it’s education or it’s prisons. And Medicaid has been growing at three and a half times our general revenue. So that has made it very difficult to fund our education.

It’s a choice Scott has made before.

University of Central Florida

University of Central Florida economist Sean Snaith.

This year he asked lawmakers to cut Medicaid spending by $2.1 billion while boosting school budgets by $1 billion. The year before, though, Scott urged lawmakers to cut K-12 spending by $1.75 billion before settling for less.

University of Central Florida economist Sean Snaith says it goes along with Scott’s jobs message. Spend more on education and you have a workforce better able to find jobs which provide health insurance, Scott’s reasoning goes.

“Was it a political decision in term of public opinion, I mean, perhaps,” Snaith said. “But I think it’s also consistent with the long-run goals — trying to build an educated, dynamic workforce that really is a very powerful attractant for businesses.”

But Orange County school board chairman Bill Sublette doubts the savings from not expanding Medicaid will make their way to schools.

“That hasn’t been the case in the past,” he says, arguing the Legislature chronically underfunds education. “And I really think it’s unfair to pit Medicaid and health care issues against public education. There’s no guarantee and frankly there’s no history of showing whatsoever that that money will go to public education.”

Orange County Public Schools

Orange County school board chairman Bill Sublette.

Sublette is a former Republican lawmaker and believes the public will see through the “crass politics” of Scott’s arguments.

Orlando mom Fowler isn’t impressed with the budget challenge facing lawmakers.

She says she makes those choices everyday.

“No sympathy,” she says. “I have no sympathy.”

Fowler has rearranged her life around her children. She took a job near their school and enrolled them in a free karate program at the local recreation center. Their doctor also lives nearby.

She likes the stability Medicaid provides, allowing her children to see the same doctor who know their history.

“I don’t want to go sit down in an emergency room,” she says. “I don’t want the emergency room bill. I don’t want strangers seeing the kids. I want somebody who knows the kids seeing the kids.

The choice shouldn’t be between health care and schools, she says. Fowler says she’d start by eliminating corporate tax cuts.

“Of course, I’m sure, it’s a tough job,” she says. “But I just feel like too often the message is ‘Oh it’s so complicated, you wouldn’t understand it.’ Don’t tell me that. That’s not OK. Aren’t we paying these peoples’ salaries?”