Surprise, surprise—thanks to Obamacare, Florida now faces a growing shortage of doctors. The Florida Medical Association is also warning that the problem will worsen if the Florida legislature follows through with Gov. Scott’s recommendation to support Medicaid expansion—a dramatic policy reversal that would offer coverage to an additional 1 million Floridians.
"Florida needs more doctors and it needs more nurses, and it needs them working together in teams," said Rebecca O'Hara, a lobbyist for the FMA.
About 15 million Floridians have health insurance today, and Obamacare, which requires most adults to have coverage by January, could add as many as 2.5 million more. One million would come through a potential expansion of the federal-state Medicaid program that Scott announced this week he was backing. The others would be the result of new mandates requiring employers and individuals to have insurance or be fined.
Currently, the state has 44,804 doctors, but about 5,600 of them are expected to retire in the next five years. And even though Florida has opened three new medical schools in the past dozen years, the state isn't producing as many doctors as it needs. Scott's budget this year has $80 million to fund programs to train 700 new residents a year, in hopes they'll remain in the state.
Of all patients, people covered by Medicaid may have the hardest time finding a doctor; only 59 percent of the state's physicians are taking new Medicaid patients, according to a Kaiser Health News study.
So the supply of doctors (particularly specialists) is running low just as the demand is about to peak with the influx of newly-insured patients and an aging baby boomer generation. This problem is not unique to Florida, however. California is also facing shortages and it seems to be a nationwide trend. The Association of American Medical Colleges estimates that by 2020, the U.S. could face a shortage of more than 130,000 physicians. The outcome, of course, will be longer waits, much higher health care costs, fewer doctor-owned practices and the strong possibility that quality of care could be diminished as physicians are stretched thinner and lawmakers propose solutions that include redefining who qualifies as a doctor.
In the meantime, however, House and Senate leaders in Florida will soon begin budget deliberations—including whether or not to expand Medicaid. Although Gov. Perry’s has now agreed to the expansion, it’s the Republican-controlled legislature that will have the final say and Florida House Speaker Will Weatherford has already expressed his skepticism. In the end, this just may be Gov. Scott trying to have his cake and eat it too:
Tia Mitchell, who covers health care goings-on in Florida’s capital for the Tampa Bay Times, told MSNBC last weekend that she thinks that Gov. Scott is “getting the best of both worlds” by stating that he favors the expansion, while not pushing hard for the legislature to authorize it.
“Number one,” said Mitchell, “he is not saying Florida will [expand Medicaid, but that] Florida should. He is being very careful to say, if the legislature does this, this is what I would sign. And that’s an important distinction…He gets to look pragmatic and you know that he’s moderating himself; he is running for reelection in about a year. However, he’s not saying he’s going to advocate for this, or, that it’s even going to make it more likely that it actually happens in Florida.”