Nobody could have seen this coming when Rick Scott ran for governor in 2010.
But there he was Wednesday, standing before the microphones in the Governor’s Mansion and announcing he would support a massive expansion of the Medicaid program.
Sometimes, to borrow a well-worn cliché, you just can’t make this stuff up.
Scott, who launched his political career by railing against President Obama’s plans to overhaul health care, said he would support a Medicaid expansion that is part of the federal Affordable Care Act, aka Obamacare. He added the caveat that the expansion should be re-evaluated after three years.
Democrats and groups like Planned Parenthood praised Scott for his stance — almost certainly one of the few times they have praised the Republican during the past three years.
Meanwhile, tea party activists and groups such as Americans for Prosperity — the conservative types heavily responsible for electing Scott in the first place — were aghast.
Scott, who is preparing for a re-election campaign in 2014, described his stance as a “compassionate, common-sense step forward.” If lawmakers go along with Scott, hundreds of thousands of Floridians will become eligible for Medicaid coverage, with the federal government paying 100 percent of the expansion costs during the first three years and at least 90 percent of the costs later.
“We have a choice — and it’s not an easy choice — but my job is to worry about every Florida family,” Scott said during the news conference at the mansion.
Scott also described the Affordable Care Act as the “law of the land,” after it was cemented by Obama’s re-election in November and a landmark U.S. Supreme Court ruling last year.
But one critical piece of that ruling — in a lawsuit spearheaded by Florida — was that states can’t be forced to go along with the Medicaid expansion. So while the Affordable Care Act will remain the law of the land, Medicaid expansion boils down to a policy choice.
Scott’s announcement also came less than two months after he got pilloried for using what critics said were inflated estimates about the Medicaid expansion’s future costs for the state. Those estimates were widely viewed as an attempt to raise doubts about going forward with the expansion.
Regardless, Scott’s new-found support is a political gamble. Ultimately, he will need the Legislature to agree to the expansion, which at least at this point appears far from certain.
Some key Senate Republicans indicated this week they might be willing to go along, and Scott could count on support from House and Senate Democrats. But House Republicans are another story, with Speaker Will Weatherford, R-Wesley Chapel, repeatedly saying he is “skeptical” about the expansion.
“Governor Scott has made his decision, and I certainly respect his thoughts,” Weatherford said in a statement emailed to reporters a few minutes before Scott made the announcement. “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.”
MEANWHILE, MORE MEDICAID
Just hours before Scott’s announcement, he and other Republicans got news they have sought for nearly two years: The federal government is poised to approve a proposal to enroll almost all Medicaid beneficiaries in managed-care plans.
Scott and the GOP-dominated Legislature approved the proposal in 2011, arguing it would help hold down costs and better coordinate care for Medicaid beneficiaries. It has been controversial, however, because Democrats and other critics contend that HMOs could squeeze the care provided to beneficiaries.
State and federal officials still have to work out the final details, but Florida received notice from Washington of an “agreement in principle.” Scott described the decision as a win for the state.
“Improving the coordination of care in Medicaid means we will be able to better manage chronic conditions and give more preventative treatments to help keep Florida families healthy,” he said.
Hundreds of thousands of Medicaid beneficiaries already get services through managed-care plans, but the changes would make enrollment mandatory. Federal officials recently approved a related proposal for Medicaid-eligible seniors who need long-term care; this week’s announcement applies to the broader Medicaid population, such as low-income women and children.
The timing of the notice and Scott’s announcement of supporting the Medicaid expansion created speculation that the issues could be linked. Bottom line, Florida leaders wanted statewide managed-care, while the Obama administration wants Medicaid expansion.
But Scott and Senate President Don Gaetz, R-Niceville, denied any connection, or quid pro quo, between the issues.
“I don’t think there’s any linkage,” Gaetz said. “There’s certainly no linkage in my mind.”
BILLS ARE MOVING (OR DYING)
Whatever their differences on the Medicaid expansion, Republican lawmakers showed this week that they remain in firm control as the legislative session gets ready to start March 5.
As an example, a House panel Wednesday approved a bill that would give the governor more power over the make-up of judicial nominating commissions. While those commissions might sound obscure and wonky, they play an important role in the process of choosing new judges.
Republicans said the changes would make judges more attuned to the wishes of the people, with Rep. Charlie Stone, R-Ocala, adding that the governor is an “elected official held accountable to the voting public.”
But Democrats, who lost a party-line vote on the bill, argued that the measure would make it easier for the Republican governor to stack the courts.
“The governor not only gets to pick who the judges are, he gets to pick who gives him the list,” said Rep. Cynthia Stafford, D-Miami. “I think that upsets the balance of power here. I think we need to keep an independent judiciary.”
Another example of Republicans flexing their muscles came as Sen. Eleanor Sobel, D-Hollywood, had to pull back a bill (SB 196) aimed at allowing civil unions, which would grant legal relationship rights to people who aren’t married.
Sobel is chairwoman of the Senate Children, Families and Elder Affairs Committee, but she decided against bringing up the measure for a vote, because it likely would have failed. Republicans make up a majority of the panel.
“I can count,” Sobel said.
Conservative opponents of the bill claimed victory. “Just hours ago, defeated SB 196, the stealth gay marriage bill,” tweeted John Stemberger, president of the Florida Family Policy Council, after the measure was postponed.
STORY OF THE WEEK: Gov. Rick Scott, a longtime critic of the federal Affordable Care Act, announced that he would support an expansion of the Medicaid program.
QUOTE OF THE WEEK: “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 after Scott’s announcement.