Scott Backs Medicaid Expansion

February 21, 2013

Calling it a “compassionate, common-sense step forward,” Gov. Rick Scott on Wednesday said he would support a potentially massive expansion of the Medicaid program under the federal Affordable Care Act.

The announcement was a dramatic move for the Republican governor, who launched his political career as an outspoken critic of President Obama’s efforts to overhaul the health-care system. The announcement also shifts the focus of the contentious Medicaid debate squarely to the Legislature, which would have to approve any expansion.

“We have a choice — and it’s not an easy choice — but my job is to worry about every Florida family,” Scott said during a news conference at the Governor’s Mansion.

Even before Scott started the news conference, House Speaker Will Weatherford, R-Wesley Chapel, issued a statement that stopped far short of an endorsement of the expansion. Weatherford said he is looking forward to the recommendations of a select committee that has been studying the Affordable Care Act and that the House’s “actions will be based on principle and rooted in facts.”

“Governor Scott has made his decision and I certainly respect his thoughts,” Weatherford said. “However, the Florida Legislature will make the ultimate decision. I am personally skeptical that this inflexible law will improve the quality of health care in our state and ensure our long-term financial stability.”

Scott said he would support expanding Medicaid eligibility for three years — a period of time in which the federal government is supposed to pay 100 percent of the expansion costs. He said the expansion would have to go through a reauthorization process after three years, which would give the state a chance to determine how it affects health-care costs, quality and access.

The move could lead to hundreds of thousands of newly eligible people signing up for Medicaid coverage. But Scott’s stance drew sharply different reactions, with Democratic lawmakers and groups such as Planned Parenthood applauding the governor and conservative activists all but calling him a traitor.

“Candidate Scott ran on fighting Obamacare and was a leader in that movement,” said Slade O’Brien, Florida director of the conservative group Americans for Prosperity. “To switch, it’s one of the biggest flip-flops I’ve ever seen. It’s going to be remarkably disappointing to the conservative base.”

The Florida Association of Planned Parenthood Affiliates, meanwhile, sent an email pointing to the fact that about one in five Floridians lack health insurance. It said expanding Medicaid will ensure that women and families have access to basic care.

“Politics should not stand in the way of Floridians getting the preventive care they need,” said Judith Selzer, vice president of public policy and communications for the Planned Parenthood affiliates.

Scott’s announcement came several hours after the Obama administration sent a letter to the state indicating it would approve a proposal to shift almost all Medicaid beneficiaries into managed-care plans. Scott and Republican legislative leaders have long championed that controversial idea, which they say would help hold down Medicaid costs and better coordinate care for beneficiaries.

Speculation swirled in the Capitol on Wednesday about whether federal approval of the managed-care proposal would be tied to state approval of the Medicaid expansion. But Scott denied such a linkage.

Scott and other Republican leaders spent more than two years fighting the Affordable Care Act, which Obama and congressional Democrats approved in March 2010. That fight included a Florida-led legal challenge that ended up in a landmark U.S. Supreme Court case. Justices upheld most of the law, but said states must be able to decide whether to carry out the law’s Medicaid expansion.

Republicans have rejected another part of the law that gave the state the choice of running a health-insurance exchange. They decided to let Washington run the exchange, which will be an online marketplace where Floridians can shop for insurance coverage.

But in explaining his decision on the Medicaid expansion, Scott said the overall Supreme Court ruling and Obama’s re-election in November cemented the Affordable Care Act as the “law of the land.” He said he has not changed his view that the best way for people to get health coverage is through their jobs, but he said his decision is aimed at making sure all Floridians have access to care.

“It is not a white flag of surrender to government-run health care,” said Scott, who made a fortune as the hard-driving chief executive of a hospital company.

Perhaps the most-important part of the expansion is that it would make Medicaid coverage available to hundreds of thousands of childless adults who in most cases are not currently eligible for the program. Also, the law would raise the income threshold for eligibility to 138 percent of the federal poverty level, which is higher than the threshold for many people currently enrolled.

The federal government has promised to pay 100 percent of the expansion costs from 2014 through 2016 and then gradually reduce that share to 90 percent in 2020. But Scott and many Republican lawmakers have repeatedly raised questions about how much money the state could be required to pay in the future.

A report released last month by the state Agency for Health Care Administration indicated that Florida could face costs of $3 billion or more over 10 years. But analysts are scheduled to meet March 1 to revise the estimates, and the new numbers could play an important role as lawmakers decide whether they want to pursue an expansion.

While Scott would require what is known as a “sunset” process after three years, it was not immediately clear Wednesday what would happen if the expansion was not reauthorized. Such a process raises the possibility of newly eligible people losing their benefits after three years.

House Democratic Leader Perry Thurston, D-Plantation, said he would prefer that Scott didn’t seek the three year-restriction on the expansion. Nevertheless, Thurston said he was pleased by Scott’s announcement.

“I am confident that this important and necessary expansion of Florida’s Medicaid program will improve the quality of health care in our state and can be achieved in an affordable manner,” Thurston said.

But with Scott running for re-election in 2014, he could face a backlash from conservatives who put him into the governor’s mansion.

“Will Medicaid expansion cover me for the knife (Scott) just buried in my back?” Henry Kelley, a tea party leader in Florida, said in a Twitter message.

Pictured: Gov. Rick Scott talks about Obamacare Wednesday at the Governor’s Mansion in Tallahassee. NSF photo for NorthEscambia.com, click to enlarge.

By The News Service of Florida

Comments

10 Responses to “Scott Backs Medicaid Expansion”

  1. curious on February 25th, 2013 6:27 pm

    Couple of years ago, some of coventry health had rx with them, then all of a sudden people had to start using Medco for rx, well I’m not 100% sure, but I believe his wife owns that company. Go figure

  2. Taxpayer1 on February 25th, 2013 1:53 pm

    “Governor Scott has made his decision and I certainly respect his thoughts,” Weatherford said.”
    “However, the Florida Legislature will make the ultimate decision.”

    This is why you never allow a Super Majority to be Elected in either party!!!! they have the power to can change laws at will…..no need for a Governor!!!!! What a mess!!!!!!!! Florida has managed to get into.

  3. bill on February 22nd, 2013 3:36 pm

    Fred,
    Your comments are right on the money. We are paying for indigents and those who don’t pay everytime we go to the hospital or pay our insurance. The medical industry plays the old shell game and the middle class pays through the nose.

    Henry,
    I agree with you also. I kind of liked Alex, even though I go for the Libertarian philosphy. I just liked the way she would call out the good ole’ boys when they were trying to do something unethical or outright illegal.

  4. Henry Coe on February 22nd, 2013 1:40 pm

    My guess, he came up with a way to take the program designed to help people and created a way to exploit it as governor.
    Remember for the next election, Corporatist hiding behind the pretense of being Conservative and saying all the right things over and over to emotionally manipulate Republican voters – using hate, fear and smear about the left is not new. They use this same scheme every election cycle and trick people to voting against the other guy whether the other guy was Bill McCullom in the primary election or Alex Sink in the general election.
    Scott spent 70 million of his own money(wink, wink) to get elected for a reason. $$$
    Just like the “not cost effective” idea of drug testing people on welfare, Scott wanted that to make money at his wife’s clinics (wink, wink) that provide drug screens. He doesn’t care about what helps the people or what is cost effective for the state. Alix Sink on the other hand, was all about that. Jus Sayin’

  5. dad on February 21st, 2013 9:05 pm

    Scott must have figured out how to screw the government out of some money again.

  6. Sandie Debuse on February 21st, 2013 6:46 pm

    When do we get to vote?

  7. fred on February 21st, 2013 9:38 am

    @bill
    There was also a news story on the AP that Florida’s request to privatize Medicaid statewide would likely be approved. Now, I ask you, doesn’t this sound “convenient” that Scott is now in favor of the Affordable Health Care Act, now that a contractor will get to manage the funds that will soon be flowing into Medicaid? Do we get that foul whiff in the air that the private contractor will be somehow connected to Scott? Should we be suspicious of the connection between these two developments?

    I am of the opinion that there should be managed basic health care for indigent patients, since we are already paying for their ER visits anyway. I wondered how long it would take for political patronage to creep its way into this.

  8. bill on February 21st, 2013 7:00 am

    “It is not a white flag of surrender to government-run health care,” said Scott, who made a fortune as the hard-driving chief executive of a hospital company.

    The Flim Flam man made a fortune because his company was stealing from Medicare!

  9. Matt on February 21st, 2013 6:40 am

    Didn’t this stooge campaign on the exact opposite platform just a couple of years ago?

  10. Betty H on February 21st, 2013 6:01 am

    Typical Rick Scott….wishy washy and has no clue how to help Florida.