Gov. Rick Scott's bold embrace of Medicaid expansion

February 26, 2013 

Gov. Rick Scott made the right call in deciding to accept the expansion of Medicaid under the Patient Protection and Affordable Care Act. This pragmatic decision not only serves the uninsured poor but also the greater good of Florida by providing relief to the medical community and health insurance policyholders saddled with the cost of free health care services to the needy.

The Legislature should agree with the governor and approve this sensible expansion to provide health care to more than a million Floridians.

Scott's reasoning should be convincing, stating that he "cannot, in good conscience, deny Floridians the needed access to health care" -- the "poorest and weakest" among us.

That alone should trump the political and ideological argument against the Affordable Care Act, which is the law of the land.

One of the nation's most ardent opponents of Obamacare, Scott found a way to bridge his financial misgivings about expansion -- by proposing a sunset provision if after three years the federal government reneges on its funding pledge.

The governor's plan would require legislators to reauthorize the program at that time, providing an escape clause that would free Florida from a fiscal mess.

The Affordable Care Act will cover 100 percent of the cost of Medicaid expansion for the first three years beginning in 2014 and then gradually dial down to 90 percent by 2020.

Scott joins six other Republican governors in reversing course and accepting expansion. As he says, the law is the law.

Florida cannot afford to reject an estimated $26 billion in additional federal Medicaid spending over the next decade while only investing $3 billion in state money. Those federal dollars will come from Floridians' pockets anyway.

The self-ordained jobs governor will indeed be creating new employment in health care with this action -- an estimated 71,000 positions, according to economic studies. That's an undeniable plus.

As we stated here earlier this month, Medicaid expansion would also absorb the costs of some state health care programs, including those for safety-net hospitals, mental health and substance abuse programs and the medically needy service. A Georgetown University study estimated those savings at $300 million in 2014 and $100 million in 2020.

Scott endorsed expansion right on the heels of the federal government's approval of a conditional waiver granting Florida permission to privatize Medicaid statewide from its previous five-county pilot program.

This managed care system, designed to save money, has been plagued with problems about red tape and poor patient care but state officials assert fixes have been implemented. That remains to be seen.

Scott's tea party supporters may be lambasting the governor for this turnaround on Medicaid with his re-election bid coming up and expansion being very popular among a majority of Floridians, but he got what he wanted in the federal waiver. For Republicans, that's an important conservative point. Plus, with his three-year sunset idea, the governor offers lawmakers an out.

Politics aside, this is about improving the health care for the "poorest and weakest" among us. That should be of paramount concern. We applaud Gov. Scott for this decision and urge the Legislature to follow suit.

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