Tanner Andrews

Florida is known for many things: beaches, warm weather, alligators, Cuban coffee in South Florida, and chicory along the Gulf Coast.

What we are not famous for is generosity toward the less fortunate. Generally, we just point and say, “At least we are not Alabama.” That is not a particularly strong boast.

Naturally, when the federal government offered to expand Medicaid, the health program for the very poor, Florida declined. The Legislature feared that, at some point in the future, the state might have to contribute.

The state is loath to contribute to anyone who does not first write them a big check. Pave Florida 2019? No problem, developer checks cleared nicely. Medicaid? Poor folks do not contribute generously to politicians, so they get last pick in Tallahassee.

You know who comes in way ahead of them? Hospitals, that is who. When Halifax explained how much profit it made on Medicaid, I saw several people picking their jaws up from the floor.

Obviously, hospitals do not want to give that money back. Hospital executives are generally well-connected. They keep the money flowing.

Still, Tallahassee politicians do not want to spend state money on the needy. Most poor people do not even donate to campaigns.

So, the state kicks the can down to the counties. Each county is required to pay its portion of the state’s Medicaid responsibility. Normally, counties do this through property taxes.

While Florida has 23 counties with hospital taxing districts, only four of them shift the burden to those districts. And of those four, only one taxes a district with no hospital. That matters, because hospitals make quite a surprising lot of money from Medicaid, despite the frequent complaints about “low” reimbursement rates.

Volusia is unique because the West Volusia Hospital Authority no longer has a hospital. There are private hospitals that receive Medicaid money, but the county cannot grab any of that. And Halifax does not want to give back much of that $40 million profit, which I can understand because I am also tight.

So it comes down to the County Council. They rob West Volusia taxpayers to enrich Halifax. And, of course, to help their own budget.

Some people think of Florida and races. Others think of Volusia government with pickup trucks carrying West Volusia taxes to Daytona. You know what people do not think of when regarding Florida — good, efficient government.

— Andrews is a DeLand-area attorney and a longtime government critic. For purposes of the column, he finds it convenient that there is so much government to criticize.


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