Medicaid Expansion – Why it Matters

Ruth Brandwein, the Health Care Committee Chair for Sarasota County’s League of Women Voters, educates us on Medicaid Expansion and the benefits it would bring to Florida State, Sarasota County, and many of our neighbors and essential workers. She explains:

  1. Current Medicaid Eligibility
    In Florida to be eligible to Medicaid, the most a family of three can earn and still qualify is about $7000 a year, or only 30% of the Federal Poverty Level. Adults with no children are not eligible at all.
  2. Coverage with Expanded Medicaid
    Under the Affordable Care Act, states can extend their Medicaid program to cover everyone who earns up to 138% of the Federal Poverty Level.
  3. How Expanded Medicaid is funded
    The Expansion is paid for by Floridian’s federal tax dollars that would be returned to the State.
  4. Financial Benefits to the State of Florida
    The Florida Policy Institute estimates that Florida’s state budget would save hundreds of millions of dollars a year if we expand Medicaid.
  5. Opportunity for State legislators
    Fortunately, Florida’s legislators and Governor DeSantis can still pass Medicaid Expansion at this crucial time.

Below is the full transcript of Dr. Brandwein’s very informative presentation.

Carol Hartz:

Hello, I’m Carol Hartz, president of the League of Women Voters of Sarasota County. I want to introduce Ruth Brandwein, chair of our healthcare committee. Ruth, who is professor and dean emeritus at Stony Brook University, has been an advocate for improving health and human services in Florida and Sarasota for the last 10 years. She helped in State Senate passage of Medicaid expansion in 2015.

Joan Ohlson:

What is Medicaid expansion and why does it matter?

Ruth Brandwein:

Good morning everyone. Medicaid Expansion is part of the Affordable Care Act, but the Supreme Court ruled that it must be left to each state to opt for its inclusion. Medicaid Expansion would cover adults aged up to age 64.  These are mostly working people with income is up to 138% of the federal poverty level, which is about $17,000 for one person, and almost $30,000 for a family of three. And the federal government is guaranteed to pay 90% of all costs, that’s by law! Now, under current Medicaid, parents with dependent children qualify only if their incomes are less than 30% of the federal poverty level, only about $6600 for a family of three! This would be a marked improvement for those families.

Joan Ohlson:

Okay, sounds good. But with the current State budget problems, and with so many more people enrolling in Medicaid now, how can we afford to open it to so many more people?

Ruth Brandwein:

Well, the difference is that with Medicaid as it is now, the federal government pays 61% of the cost and the State government pays 39%. With Medicaid Expansion, the federal government would pay 90%. The State would only pay 10%. Actually, it will help the State budget, because with Medicaid Expansion, the State will bring in almost $200 million more in 2022-23 than it does now, and that’s net! That’s after all the costs for the new Medicaid. Even after the State’s 10% for new recipients, there would be savings, because many people who are now on traditional Medicaid, like pregnant women, disabled people, the medical needy and others, would be eligible for the 90% federal enhanced match instead of the current match.

Ruth Brandwein:

38% of the States and DC have now adopted Medicaid expansion, and as you can see on this slide – ALL have saved money. None of them that have started Medicaid expansion have quit, or have opted out. In 2019, Michigan, for example, saved $140,000,000. Arkansas saved $137,000,000. And Louisiana saved $363,000,000.

There’s also the multiplier effect — that is a 1.5 to 1.7 increase. That means that because of additional salaries, Medicaid, medical equipment, its fees and other things, for every dollar spent on Medicaid, it would add between $1.50 to $1.70 into the economy through that additional spending.

Joan Ohlson:

Well, what difference will it make for Sarasota?

Ruth Brandwein:

I’m glad you asked that. As you can see from this slide, 10,790 people in Sarasota were uninsured for Medicaid expansion before the pandemic. We don’t have the new figures, but it’s certainly well over 11,000 people now in Sarasota alone.  Now remember, almost 10,000 more people were unemployed in 2020 than in 2019. Many lost their health insurance, and more than 19% of the unemployed have no health insurance.

If more people are covered, they will not have to use the emergency rooms. Right now, 36% of people in Sarasota use the emergency room or urgent care when they need health care. Instead, they’ll have regular doctor visits and screening for chronic health issues like diabetes and high blood pressure. Prevention and treatment can begin earlier. That will be saving costs of high hospital bills in the later stages of disease.

Moreover, since COVID, there’s been a tremendous increase in depression, suicide, alcohol and drug abuse. Medicaid Expansion would cover 90% of treatment costs for eligible adults. Right now, the county and state pay for medical care, including mental health and substance abuse services in jails and prisons. 90% of that would be covered by Medicaid expansion. It’s a no-brainer!

Sarasota County Department of Health and Human Services contracts with local agencies to provide some mental health, drug abuse, alcohol and others services. Instead of the 100% that the county now pays for these services, the cost would be reduced to only 10% for any recipients who would be eligible for Medicaid expansion.

Joan Ohlson:

So it may save the government money, but what will it do for me and for the other people in Sarasota?

Ruth Brandwein:

Well,  the biggest reason for personal bankruptcy is medical and hospital bills. People shouldn’t have to choose between paying their mortgage or putting food on the table, and paying their medical bills. Testing and treatment for COVID-19 would be covered. Now, those without private insurance or Medicaid coverage, or Medicare, have to pay out of pocket. Early screening would be covered, so more preventive and early treatment for cancer, diabetes, high blood pressure, and other  chronic illnesses would be covered.

Health care coverage reduces the premature death of those people 55 to 64 years old by about 40 to 60%. It will also reduce racial disparity that we now have, both in our county and nationwide, in maternal and infant death, cancer, heart, and kidney disease.

With health coverage, you can look for, keep, or change a job without worrying that you would lose your health coverage.

Joan Ohlson:

Okay, you’ve convinced me. Now what can I do?

Ruth Brandwein:

Well, first you can join Voices for Health. That’s a statewide coalition of over 100 civic health, faith, and labor organizations around the state.

If you’ve had a problem accessing health care because of lack of health insurance, you can tell your story at That’s

Also, tell your friends and family to support Medicaid Expansion.

The League of Women Voters has speakers. Invite us to speak at your club, church, synagogue or mosque, in, in your condo or home-owners association meetings, or other groups to learn more about Medicaid expansion.

You can write a letter to the editor in favor of Medicaid Expansion.

In the coming State Legislature, Senate Bill 556 and House Bill 341  have just been introduced. Please contact your local State Senator, who is Joe Gruters here in Sarasota, to cosponsor Senate Bill 556 (Eligibility for Medical Assistance and Related Services), or your House member, and ask them to cosponsor one of the Medicaid Expansion bills.

As you can see in the slide, the  phone numbers and emails for our State Senator and our local legislators. If you live outside of Sarasota, you can go to the State House and Senate websites to find out who  your representatives are.

Now, we also have a fallback position. We hope these bills will pass and that the governor will sign them, but just in case that doesn’t happen, we will start a petition campaign to allow voters themselves to vote for it on the 2022 ballot. Several states have approved Medicaid Expansion through this process, both red and blue states. So, make sure to sign the petition if it is asked.

I like to invite everyone to a League of Women Voters Hot Topics presentation on Tuesday, February 16 at 7 pm. Anyone can register. You don’t have to be a League of Women Voters member. All you have to do is go to this website to – and then scroll down to where it says League Events and you’ll find it, and just register. Register here.

Thank you for joining us on this YouTube today. I hope that you got more understanding of Medicaid Expansion, and please take action. Thank you.


Legislators’ Contact Information


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