MIAMI — Prospects for Medicaid expansion in Florida, which was embraced, improbably, by the state's Republican governor in February, are all but dead this year.
With the Republican-dominated Legislature preparing to leave town on Friday, time has run out to draft a compromise bill between the House and Senate that would expand Medicaid with the help of billions of federal dollars. House Republicans voted last week to reject the Senate plan, which would take the federal money and use it to add low-income Floridians to private insurance plans.
The Legislature's inability to agree means that more than a million low-income Floridians will remain without insurance, at least in the short term. Florida has one of the nation's highest rates of uninsured people. Public hospitals also will suffer because they will continue to have to care for those one million uninsured who seek treatment in their emergency rooms.
Florida must have a plan to expand coverage passed and approved by the federal government as of Jan. 1, 2014, or it will lose an estimated $1 billion in Medicaid dollars in the first year. The federal government will fully finance the new enrollees for the first three years.
Outraged and outnumbered, Democrats called a protest on Tuesday to pressure House Republicans into changing their minds. They instituted a rare "slowdown" in the House, relying on a parliamentary tactic that requires a full reading of all House bills ready for floor votes. An Automated House Reader called "Mary," used for just such a protest, was called to duty by House Speaker Will Weatherford, and spent part of Tuesday and all day Wednesday speed-reading through bills.
"It's unfortunate that we have had to take such unusual action today, but my Democratic colleagues and I believe that a drastic situation requires drastic tactics," said Perry Thurston, the House Democratic leader, announcing the protest. "The 1.2 million people who can be provided medical coverage under proposed legislation may not be aware of what's transpiring in Tallahassee."
Democrats asked the governor, Rick Scott, either to call a special session of the Legislature to address the issue or to veto the budget in response. If he does not, the Legislature can try to tackle Medicaid expansion when it convenes in 2014, but by then it will be too late to collect the $1 billion.
In the Senate chamber, Democrats expressed deep frustration.
"I rank this as the biggest disappointment I have encountered as a member of the Florida Legislature," said Senator Arthenia Joyner. "It is unconscionable."
Democrats called on Mr. Scott, who has a relatively distant relationship with the Legislature, to use his power as governor to strong-arm House Republicans.
In a rare visit to the Florida Senate, where she once served, United States Representative Debbie Wasserman Schultz, who is chairwoman of the Democratic National Committee, chastised Mr. Scott for failing to lobby House Republicans more aggressively.
"While it's very nice that Governor Scott has had a deathbed conversion and decided that he does want to accept the federal funds, it's time for him to get off the sidelines," she said. "Either he is for accepting those funds and is willing to use his clout and his weight and put the full weight of his office behind that position, or he is not."
Ms. Wasserman Schultz went on to describe state House Republicans as "spoiled children who are stomping their feet because they didn't get their way."
Health care lobbyists said Mr. Scott was serious about Medicaid expansion at the start of the legislative session. Once it became apparent the House would not budge, he put all of his energy into teacher pay raises and a tax cut for manufacturers, they said.
"Given the position of the House and Senate, the way he acted was, 'Let's focus on what's achievable right now and get back to that,' " said a longtime hospital lobbyist in Tallahassee, Mark Delegal.
Asked by reporters last month whether he was forcefully pushing Medicaid expansion, Mr. Scott replied, "Both the House and Senate know exactly where I stand."
Florida now cares for 3.3 million people through Medicaid, using, in large part, a network of managed care programs.
Lizette Alvarez reported from Miami, and Christine Jordan Sexton from Tallahassee, Fla.
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