Florida governor flips on Medicaid Expansion

In a major policy reversal, Gov. Rick Scott of Florida on Feb. 20 announced that he would support expanding his state’s Medicaid program to cover more poor residents, accepting the federal government’s offer to pay for a three-year expansion of the program in Florida, under the terms of the Affordable Care Act (ACA), signed into law in March 2010; but the final decision on that option will be up to the Florida Legislature.

The policy shift is particularly significant, given that Gov. Scott had joined a multi-state effort to challenge the ACA in the federal courts, an effort that ultimately led to the Supreme Court’s decision in June 2012, which affirmed the constitutionality of the ACA overall; at the same time, the nation’s high court ruled that the federal government could not force the state governments to expand their Medicaid programs. Since then, a number of governors have announced that they would not expand their Medicaid programs.

“While the federal government is committed to paying 100 percent of the cost, I cannot in good conscience deny Floridians that needed access to healthcare,” Mr. Scott said at a news conference that the Miami Herald described as being “a hastily called news conference at the Governor’s Mansion” in Tallahassee.

Scott, once the top executive at the old Columbia/HCA hospital system from the late 1980s into the late 1990s, said, “We will support a three-year expansion of the Medicaid program under the new healthcare law as long as the federal government meets their commitment to pay 100 percent of the cost during that time,” Scott said, as reported in The New York Times.

Nonetheless, Scott said that Florida would not create its own health insurance exchange in order to comply with another provision of the law. As a result, the federal government will create an exchange for Floridians.

In any case, Gov. Scott’s announcement may not be the last word in this situation.  As the Miami Herald noted, “Scott was careful to point out that the Republican-controlled Florida Legislature will ultimately decide whether or not his proposal is worth implementing. That is far from certain, particularly in the more partisan House,” the newspaper noted, quoting the governor as saying, “It is not a white flag of surrender to government-run healthcare,” perhaps anticipating a political backlash from conservative Republicans in the state’s legislature.