Governor Rick Scott says the state will expand access to Medicaid under the Affordable Care Act to more low-income Floridians. The announcement marks a dramatic shift in a Governor who was once one of the leading opponents to the federal healthcare law.
“While the federal government is committed to paying 100 percent of the cost, I could not, in good conscience, deny Floridians that needed access to healthcare," Scott said Wednesday, hours after the state got word from the Federal Centers for Medicare and Medicaid services that it was poised to approve Florida's request to transition Medicaid into a managed care system.
The federal government says it agrees with Florida’s decision to transfer Medicaid to a managed care model, but wants a few more guarantees on consumer protections before granting full approval. That was apparently good enough for Governor Scott, who has said previously that he would base his decision about the expansion on whether Florida got permission to privatize Medicaid.
The Governor was once a staunch opponent of the federal healthcare law. He created a group that campaigned hard against the law, and used it to launch his 2008 gubernatorial campaign. Florida even challenged the constitutionality of the law before the U.S. Supreme Court. But now Scott says while he’s still against the law, his decision comes down to where and how that Medicaid money gets spent:
“To be clear, our options are either having Floridians pay to fund this program in other states while denying healthcare to our citizens, or using federal funding to help some of the poorest in our state with the Medicaid program as we explore other healthcare reforms," he said.
But that choice has angered many among the Governor's conservative base.
“It’s really unfortunate to see Governor Rick Scott flip like this and support something he’s opposed to ever since he was candidate Scott," said Abigail MacIver, Policy Director for the Florida arm of American’s For Prosperity, a limited-government think tank.
While Florida's Democratic lawmakers issued statements in support of Scott's decision, The Florida Democratic Party accused the Governor of flip-flopping, but Scott defended his policy decision.
“It is not the end of our work to improve healthcare. It is not a white flag of surrender to government-run healthcare," Scott said.
Advocates like the SEIU healthcare workers union says it’s pleased the Governor has finally come around to supporting the expansion.
“We believe in miracles in the SEIU and as healthcare workers we salute the leadership of Governor Scott to take a stand for Florida’s uninsured," said Monica Russo, President of the SEIU of Florida.
Meanwhile, the federal Centers for Medicare and Medicaid Services gave tentative approval for the state to move forward with its plan to privatize the Medicaid program is also garnering some praise from consumer advocates. The transition would move almost all the state’s three million-plus recipients into a managed care style-system and give insurance companies lump-sum payments to cover their care. Healthcare advocates have been wary of the managed care—fearing insurers will try to cut corners in order to squeeze out profits. In order to get full approval for the program, the federal government wants more guarantees on consumer protections and oversight of insurers.
“CMS is moving in the right direction in requiring the state includes more consumer input, in fact that was explicit in the letter from CMS to AHCA [Agency for Healthcare Administration] saying we want to see the inclusion of stakeholders and consumer input and that was one of the three main points they made in their letter," said Laura Goodhue, Executive Director of the healthcare advocacy group Florida Chain.
The federal government has already granted Florida permission to move people in long-term care into a managed care system.
But Florida’s Republican leaders are less enthused with the Governor’s plans. In a statement, House Speaker Will Weatherford says while he respects the Governor’s decision, the ability to expand Medicaid is ultimately up to the legislature. And Senate President Don Gaetz says he’s waiting to see what legislative committees studying the issue recommend. Under Scott’s plan, Florida would allow the expansion for three years—the same amount of time the federal government has agreed to cover 100 percent of the costs for an estimated 1.2 million Floridians that could gain insurance under the expansion.
Here's the full press conference: