Economists gauge whether FL would have to fund abortions with Medicaid under ballot initiative

By: - November 1, 2023 5:09 pm

Mifepristone, one of two drugs used in a medicine-induced abortion is shown here (Photo by Robin Marty via Flickr | CC-BY-SA 2.0)

A chief analyst in the Governor’s Office said the abortion-rights ballot initiative is unclear about whether Florida would have to allow Medicaid funds to go toward abortions —an issue that came up Wednesday when economists were working on estimating the financial impact of the initiative on state and local economies.

Estimating the cost is part of the process of getting the initiative from Floridians Protecting Freedom to the ballot in November 2024. Florida law states that a group of four state economists — sitting as the Financial Impact Estimating Conference — must examine the potential costs and revenues of every ballot initiative. Of course, they have to come to a consensus about what factors come into play.

The potential for Medicaid-funded abortions appeared to be important for Brea Gelin, the analyst in the Executive Office of the Governor. She first raised this issue during the Oct. 19 meeting and again in today’s meeting.

“To me, there’s still uncertainty,” Gelin said. “I understand the Hyde Amendment says you can’t use federal funds, but I just am not sure that you wouldn’t be forced to use state funds because, like you said, some of the statutes right now that are prohibiting state funds would be invalid, possibly.”

Using federal Medicaid funds to cover an abortion has been banned since 1977 when the U.S. government implemented the Hyde Amendment. The amendment provides exceptions for rape, incest and if the procedure is necessary to save the pregnant person’s life. Medicaid is the health care program for low-income families and persons and is funded with federal and state dollars.

A Florida Supreme Court case provides guidance regarding state funding. In 2001, the court decided the state did not have to fund abortions in the case Renee B. v. Florida Agency for Health Care Administration. Florida is in the majority in this decision. Only 17 states provide funds for all or medically necessary abortions, according to an analysis from KFF, a health policy research organization. Of the 17 states that fund abortion, courts obligated nine of them to do so, according to the Guttmacher Institute, a reproductive rights research and policy NGO.

Amy Baker, coordinator for the Office of Economic and Demographic Research, is one of the four members of the Financial Impact Estimating Conference tasked with determining potential costs and revenues of the abortion-rights ballot initiative. Screenshot taken from Florida Channel on Nov. 1, 2023.

The other three members of the group (Amy Baker, coordinator for the Office of Economic and Demographic Research; Vince Aldridge, staff director for the House Ways and Means Committee; Azhar Khan, staff director of the Senate Finance and Tax Committee) said they did not think the ballot initiative would not give someone the right to have their abortion funded by the government.

But Gelin suggested that they add language stating the ballot initiative language could lead to litigation regarding state funding considering the nine states that provide funding as a result of litigation.

“When I look at the way the [Floridians Protecting Freedom] amendment is phrased, to me, it removes the restrictions but doesn’t require funding. So that’s my plain reading. How the litigation pans out. … In almost all difficult situations, you don’t know what the courts will say,” Khan said. “I was comfortable in saying it requires the removal of restrictions, doesn’t require any action other than that on the state’s part.”

So far, the group has agreed that the 150-word summary that would appear on the ballot would indicate that the impact could not be determined because of the Florida Supreme Court’s pending decision on the challenge to the 15-week abortion ban.

However, that agreement is not formal until after the last meeting on Nov. 16. During the Wednesday morning meeting, the group discussed a draft of the other documents they have to publish: A 500-word summary available at polling places and a financial information statement that includes all the factors they considered when making their decision.

Ultimately, the group decided to continue discussing the issue during the final meeting on Nov. 16. Other topics the group will detail in the financial impact statement include the effect of declining birth rates on pre-K education and government health care coverage, the effect on the criminal justice system and potential revenues from people from other states traveling to Florida to get an abortion.

Once the group completes the materials, they will send them to Attorney General Ashley Moody and Florida State Secretary Cord Byrd. Then, the Florida Supreme Court has to approve it.

However, Moody asked the court to bar the ballot initiative in a brief filed this week.

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Jackie Llanos
Jackie Llanos

Jackie is a recent graduate of the University of Richmond. She has interned at Nashville Public Radio, Virginia Public Media and Virginia Mercury.