Frank Underwood is of course the lead antagonist in Netflix highly thought of and critically acclaimed political drama “House of Cards,” someone who always does the unexpected to improve his position in politics. Gov. Rick Scott leads the state of Florida and his latest “flip-flop,” on Medicaid expansion has to make voters wonder if he has seen too many episodes of “House of Cards.”
Many will recall that in the build up to running for office in 2013 Scott, had many times voiced his support for expanding Medicaid. But Monday he expressed strong doubts about a government proposal to extend federally subsidized health insurance to nearly 800,000 poor Floridians.
“We still have several weeks left for budget negotiations,” Scott said in a brief statement. “However, given that the federal government said they would not fund the federal LIP program to the level it is funded today, it would be hard to understand how the state could take on even more federal programs that CMS could scale back or walk away from.”
Responding to Monday’s statement, Senate President Andy Gardiner, R-Orlando, pointed out that the Senate shares many of the governor’s budget priorities, including tax relief and record education funding.
“However, if our state is forced to make up the difference of $2.2 billion in hospital funding, every area of our budget will be impacted,” Gardiner said.
A spokesman for the U.S. Department of Health and Human Services rejected Scott’s claim that the federal government could walk away from its obligation to fund Medicaid expansion.
“The law is clear: Federal funding for Florida’s Medicaid expansion covers 100 percent of the costs of newly eligible individuals through 2016 and will never fall below 90 percent,” agency spokesman Ben Wakana said. He added that the federal government has “proven itself willing to work with any state interested in expanding Medicaid, and [has] consistently said that a Florida solution would reduce costs for hospitals that are typically passed on to taxpayers and expand access to quality health care for more Floridians.”
Meanwhile, Scott’s decision to oppose Medicaid expansion in Florida puts at least 800,000 Floridians at risk of being unable to pay for their health care. Voters who re-elected him in 2014 under the assumption that he would approve Medicaid expansion took him at his word, which in the case of the Gov. Scott is not necessarily a good idea.
Once the federal government cuts funding to the Low Income Pool, or LIP, which helps hospitals that treat poor patients, it will be Florida taxpayers who will be on the hook for Gov. Scott’s lack of leadership on this issue.
Florida’s Republican-controlled Senate, defying a powerful conservative advocacy group, has passed a budget bill that includes a customized version of Medicaid expansion under the Affordable Care Act.
The Florida Senate led by Republican Andy Gardiner and other top GOP members showed the rare ability to actually work out a bi-partisan bill and had engaged in a very successful dialogue with Washington. They made great progress with the Centers for Medicare and Medicaid Services(CMS),and were working closely together to craft a plan expand services to the states poor and uninsured. (Scott made it sound like the two sides were no longer talking when in fact the chief CMS negotiator simply took a few days off for the Passover holiday.)
Things were lookng so positive that the Florida Senate unanimously passed budget bills that included expansion of coverage for adults with incomes up to 138% of the federal poverty level. The bill would change the state’s private exchange, known as, Florida Health Choices, into a Medicaid plan exchange called the Florida Health Insurance Affordability Exchange.
By making that change Florida’s federal Medicaid expansion dollars would be used to buy private coverage for qualifying residents. Beneficiaries would have to pay premiums ranging between $3 and $25 based on income. Nonpayment would result in individuals being moved to inactive status, and they could not regain coverage for six months.
But strong opposition from the Florida House of Representatives was only enhanced by Scott’s Monday remarks. Back over at the GOP led Senate they were wondering what happened to the Gov. Rick Scott circa 2013.
“Expanding access to Medicaid services for three years is a compassionate, common sense step forward,” Scott said in 2013. “It is not the end of our work to improve health care. And it is not a white flag of surrender to government-run health care. I am committed to working every day to improve access to affordable, high-quality health care in Florida, while also protecting taxpayers and keeping our economy growing to create more jobs.”
Nationally, his statement Monday coming out against the Senate plan brought plenty of national headlines including “flip-flop” (Talking Points Memo); “walking back” (National Journal); “disgraceful Obamacare reversal” (Salon) and “change in course” (by The Associated Press, which reported it first).
One of the state’s top a bi-partisan coalition of individuals and business groups known as A Healthy Florida Works, said they were hopeful Scott would come around.
“The Florida Senate, led by President Andy Gardiner, has put forth a comprehensive, responsible approach to extending health care coverage,” spokeswoman Jennifer Fennell said. “We remain optimistic that the Legislature and governor will move forward with this comprehensive plan that protects Florida families and businesses.”
Does Gov. Scott have one more “flip-flop,” left in his bag of tricks? Can he channel Frank Underwood and turn this negative into a positive by supporting his fellow Republican Andy Gardiner? One never knows what will come out of Tallahassee, but stay tuned.