Published: Jul 29, 2014 4:03 PM EDT

FORT LAUDERDALE, Fla. (AP) - The powerful Florida Medical Association has come out in support of expanding Medicaid to roughly 1 million Floridians, choosing sides in a controversial political issue that has divided state lawmakers.
    
The organization passed a resolution at its annual conference last weekend saying it will publicly support Medicaid expansion, which would bring in nearly $50 billion in federal funds over the next decade. However, the association says it supports the move only if it improves access to patient care and increases Medicaid reimbursement rates to doctors.
    
Increased access to care will only come "if there are adequate numbers of physicians to care for these patients," the organization said in a written statement, adding that current reimbursement rates are "grossly inadequate and serve as a disincentive to physician participation."
    
The debate over Medicaid expansion, a key part of President Obama's health law, has been contentious in Florida. The Sunshine State has one of the highest uninsured rates in the country. That pent-up demand was clear as nearly 1 million Floridians bought private insurance through the federal health marketplace. But another million fell into a gap: too poor to qualify for tax credits in the marketplace, yet earning too much to qualify for Medicaid.
    
In a surprise move two years ago, Gov. Rick Scott said he supported Medicaid expansion, but he never made it a priority. In an unlikely alliance last year, Scott, the Senate, House Democrats, Florida hospitals, health advocates and a diverse mix of business and labor groups all lined up to support a bill that would have drawn down federal funds and given it to Floridians to purchase private insurance. But House Republicans blocked the legislation.
    
The federal government has agreed to pay 100 percent of the costs for three years and start phasing down to 95 percent in 2017. House Speaker Will Weather and fellow Republicans have expressed concern that the feds will not make good on that promise, leaving the state on the hook for the tab.
    
Democrats and health advocates urged Scott to hold a special session on Medicaid expansion and have repeatedly highlighted the stories of working people who would benefit if the state expanded the program to include those earning up to 138 percent of the poverty level. That's roughly $11,000 a year for a single person and about $19,500 for family of three.
    
But the issue was a non-starter during the last Legislative session. And as Scott campaigns for re-election, his support for expansion appears to be fading.
    
U.S. Rep. Elijah E. Cummings, the ranking member of the House Committee on Oversight and Government Reform, wrote to Scott and five other Republican governors Tuesday noting that fellow Republican Governors Jan Brewer, Chris Christie and John Kasich have all found ways to make Medicaid expansion work in their states. Cumming asked Scott to provide data on the numbers of jobs lost or created by not expanding Medicaid.
    
Meanwhile, health advocates have changed their strategy, allying themselves with the business community and hoping to convince Republicans that healthy workers will be a boon for employers.
    
Families USA, an advocacy group supporting the overhaul, released a report Tuesday noting that half of the roughly 1 million Floridians who would benefit from the expansion are working or have worked in the recent past. The report noted 82,000 work in food service, 58,000 in cleaning and maintenance and 41,000 in transportation, highlighting the waiters, hotel maids and taxi drivers who undergird Florida's economy.
    
"It will help develop a healthier, more productive workforce and that's particularly important to an economy like ours with tourism at the epicenter," said Julio Fuentes, President and CEO, Florida State Hispanic Chamber of Commerce.
    
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