Senate President Andy Gardiner, R-Orlando, left open the possibility Wednesday that his chamber will consider an expansion of health coverage for low-income Floridians.
Gardiner described as "intriguing" a proposal that would accept billions of dollars available under the federal Affordable Care Act and provide coverage through private insurers.
A coalition that includes business groups and hospitals is pushing the proposal, and Gardiner was asked about it at a meeting with reporters.
"Certainly the Senate has shown a willingness," he replied. "We have had a couple of bills the last couple of years, and we are willing to have that discussion."
Some elements of the proposal, which would need state and federal approval, are similar to a plan pushed by Senate Republican leaders in 2013. House leaders refused to approve the Senate plan or a Medicaid expansion, arguing in part that the state could not rely on promises of federal funding.
The new proposal -- dubbed "A Healthy Florida Works" -- would target 800,000 to 1 million people who otherwise would be part of a Medicaid expansion. It would be largely funded through billions of dollars in federal money available under the Affordable Care Act, but would use a state-operated private insurance "marketplace," where eligible people could choose among health plans.
Also, it would require participants to be involved in such activities as job searches, job training or educational programs.
Senate Rules Chairman David Simmons, R-Altamonte Springs, said Wednesday he's waiting to see the legislative language the coalition will offer. But if he likes the plan, he'll sponsor it.
"We want to make sure we're not using a failed concept, which is the existing Medicaid," Simmons said. "We as Republicans have a long history of helping others help themselves. I am hopeful that what these stakeholders are presenting will in fact meet that criteria, and if it does, I will be strongly supporting it."
Another potential supporter is Senate Health and Human Services Appropriations Chairman Rene Garcia, R-Hialeah.
"I think it is more palatable, not only to members of the Senate, but I think it should be something where our House members can feel comfortable compared to straight-up Medicaid expansion," Garcia said.
The Affordable Care Act, better known as Obamacare, has long drawn opposition from Florida Republican leaders. A lawsuit led by Attorney General Pam Bondi and former Attorney General Bill McCollum scuttled part of the federal law that could have effectively forced states to expand Medicaid.
House Speaker Steve Crisafulli, R-Merritt Island, has said he won't consider Medicaid expansion. But on Wednesday, responding to Gardiner's remarks, he said he might consider expanding health care coverage via the private sector.
"It is too early to tell whether a bill will be filed in the House or the Senate on the matter," Crisafulli wrote in an email. "In previous years, we have had robust debate and the House voted in favor of a fiscally responsible, state-run, private insurance plan that would cover hundreds of thousands of Floridians. I welcome all ideas that meet the House's principles for a sustainable, effective, private-sector-based solution that meets Florida's needs."
The plan is backed by groups such as Associated Industries of Florida and the Florida Hospital Association, which contend that it will save businesses billions of dollars while providing 121,000 new jobs and $541 million in local government revenue.
The proposal contends that Floridians are paying federal tax dollars that flow to other states that have expanded health coverage under the Affordable Care Act.
"Florida policymakers have an opportunity to provide basic health care services for those most in need while also ensuring the state's financial security,'' the proposal said. "Florida dollars have already paid for this. We should accept the available federal funds so we can get back what we sent to Washington, D.C., rather than allowing those dollars to fund programs in other states."
Bruce Rueben, president of the Florida Hospital Association, said another way the proposal would save the state money is by helping keep sick people out of emergency rooms.
"When people who have no health insurance seek health care, they usually wait until they absolutely have to have it," he said. "They wait, because they have no way to pay for it. They wait and wait and wait until they're sicker, and by the time they're seen in a hospital, now it's going to be very expensive, and their chances for a good outcome are lower."
Gov. Rick Scott's office referred a reporter to a Dec. 9 press conference at which Scott said he hadn't seen the proposal yet. The governor added that he was proud of the "historic" Medicaid overhaul the Legislature passed in 2011, moving recipients of the program to managed care.