Governor Scott Flips on Medicaid Expansion

BRADENTON – Florida Governor Rick Scott continued his ideological shift this week with an announcement Wednesday that he now supports expanding Medicaid and funneling billions of federal dollars to Florida, a significant reversal that could bring health care coverage to more than a million Floridians currently without. Throughout his campaign for governor in 2010, Scott pledged not to allow expansion.

“While the federal government is committed to paying 100 percent of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care,” Scott said at a press conference Wednesday. “We will support a three-year expansion of our Medicaid program under the new health care law.”

The announcement came only hours after the U.S. Department of Health and Human Services announced it would allow Florida to put all Medicaid recipients into managed care. HHS will, however, retain oversight and can rescind its approval if the state fails to meet certain quality standards.

Scott, who previously called the new regulations "job killers," while running for the office as a small government Republican, after heading a movement to defeat "Obamacare," surprised many when he began using compassionate language in referring to the "poorest and weakest" Floridians.

Scott has earned the ire of many of his supporters, especially in the Tea Party Wing. Steve Vernon, President of Tea Party Manatee said that his group was not pleased with Scott's decsion.

"We believe the Medicaid expansion, as part of the implementation of Obamacare, will be detrimental to Florida in the long run," said Vernon. "As is customary with federal government programs, they lure states into adopting programs like this by promising Federal monies, then, as time goes on, they become financial millstones around the States necks."

Meanwhile, a wealth of studies have supported the case for expansion. A report released the same day as Scott's announcement claimed that Medicaid expansion in Florida would create 71,300 jobs and $8.9 billion in economic activity. According to the report from expansion advocates Florida CHAIN and Families USA, an estimated 1.8 million people gain coverage through the Medicaid expansion. An previous study done for the Florida Hospital Association estimated that the expansion would add 56,000 jobs to the state.

Another study by the Georgetown University Health Policy Institute suggested that Florida could save up to $100 million a year by expanding Medicaid coverage and scaling back on state-funded mental health and substance abuse service programs, as well as other hospital safety net funds, which it said patients wouldn't have to rely on as often if they were covered by Medicaid. The report estimated that between 800,000 and 1.3 million additional Floridians could qualify for coverage if the state expanded its Medicaid rolls.

A study in The New England Journal of Medicine by Harvard’s School of Public Health, which examined Arizona and Maine's expansion found that expanding Medicaid to low-income adults led to significant gains in coverage and access to healthcare, along with improved health and fewer deaths in the states. Those states also received much less federal reimbursement than Florida would receive – 100 percent in the first three years, and no less than 90 percent after.

Now it goes to the Florida Legislature, who must vote to allow individuals earning less than 133 percent of the poverty level to qualify for Medicaid, for the "agreement in principle" between the state and HHS to result in the waiver.