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Summary Minutes:Regular City Commission Meeting May 21,2015 City of Sunny Isles Beach,Florida <br /> preventive care,wellness care,things that are both more effective and would result in a better <br /> outcome and also be cheaper. Keep in mind that even though the Feds provides part of the <br /> cost of indigent care, we also contribute to that cause through our local taxes to support <br /> institutions like Jackson Memorial or Hollywood Memorial and so theoretically you should <br /> have some beneficial effects all around. The problem is that there is a gap in coverage. A lot <br /> of people think this issue about Medicade is designed to help the poorest people in our State <br /> and there is nothing wrong with that but the fact is if you are really poor in Florida,you have <br /> health insurance. You have Medicade, you are covered. Past a certain income level, if you <br /> need health insurance you qualify for subsidies under the Affordable Care Act,under Obama <br /> Care, that can help you buy your health insurance. But there is a gap from about 20 to 55 <br /> Thousand Dollars in income and if you fall into that gap you make too much money to have <br /> Medicade but not enough to qualify for subsidies for Affordable Care Act or Obama Care <br /> Insurance. That means that people who have gotten a job and are working sometimes two <br /> jobs because they can't get benefits,are out there and their initiative and work is awarded by <br /> being told you have lost your health insurance, you make too much money which makes no <br /> sense. The State Senate has almost the same composition as the State House he serves in. It <br /> is roughly 2 to 1 Republican but almost unanimously our State Senate has come up with a <br /> proposal that would expand access to healthcare coverage,they call it FHIX, it is a fix to the <br /> problem, the Florida Health Insurance Exchange. It is based on private insurance but it <br /> would allow us to not only draw down that $2.8 Billion in federal money to expand <br /> healthcare coverage this year,but probably if we did that, some kind of a deal could be made <br /> with the federal government for this other$2.2 Billion in funding. The total is$5 Billion and <br /> in fact,over a ten-year period the federal government is willing to give to the State of Florida <br /> $50 Billion to expand healthcare coverage, initially paying 100% of the cost and over the <br /> course of these years declining to where they would still pay 90% and keep in mind, that is <br /> our money. We paid that money in taxes, we are a donor state, and they are offering to give <br /> us back$50 Billion,and somehow we haven't been able to figure out the right answer to that <br /> which is yes, thank you. And so that is where it stands, the Senate has a plan in place, for <br /> reasons that they would be better able to explain than him or his colleagues in the House,and <br /> the House leadership has not thought that is the right way to go, and that is the impasse that <br /> we face. Personally he thinks we should be taking their money and thank everyone that has a <br /> job and healthcare,we should expand it so we have better outcomes for people,and it would <br /> be the fiscally responsible thing to do because it actually will reduce healthcare costs. <br /> Representative Geller said there were a lot of things that they were not able to get done <br /> during this session. There is a horror going on in our prisons that has been very thoroughly <br /> reported and we couldn't agree between the Houses on a"Prison Reform Bill". There have <br /> been promises for more money for education but if we don't accept some of this federal <br /> money they may need to use that education money to help cover this indigent care gap. <br /> There are problems with waiting lists for affordable housing, we continue to incarcerate <br /> people who are mentally ill instead of having treatment beds available because again it is a <br /> funding issue. The budget that the House has proposed for the State of Florida is $75 <br /> Billion,the budget that the Senate has proposed counting these two pots of federal money is <br /> $80 Billion. $5 Billion on that size budget, that is a really significate portion of the State <br /> budget and so this is not just about health care. 75% of the voters in this State voted for <br /> Amendment One to protect our land and our water more effectively and we haven't reached <br /> an agreement as to how that is to happen. That $5 Billion spread across our State budget <br /> 4 <br />