Republican Governor of Florida Says State Wonft Expand Medicaid
Published: July 2, 2012 - New York Times
WASHINGTON — In another sign of resistance to
President Obamafs health
care overhaul, Gov. Rick
Scott of Florida, a Republican, said Monday that his state would not expand
its Medicaid
program.
Florida is the largest state to say so firmly that it
will take advantage of a new option granted by the Supreme
Court decision on the health care law.
The 2010 law calls for a sweeping expansion of
Medicaid, to add 17 million people to the rolls, accounting for half of all the
uninsured people expected to gain coverage nationwide.
gFlorida will opt out of spending approximately $1.9
billion more taxpayer dollars required to implement a massive entitlement
expansion of the Medicaid program,h said Mr. Scott, a former health care
executive.
More than one-fifth of Florida residents — roughly 4
million of 19 million people — lack health insurance.
Mr. Scott also rejected another provision of the new
federal law, saying Florida would not set up a health insurance exchange, or a
regulated market where people can shop for coverage.
The governor acknowledged that for three years, from
2014 to 2016, the federal government would pay all the costs of covering people
newly eligible for Medicaid. But, he said, gthe burden increasingly shifts to
Florida taxpayers in future years.h
Mr. Scott said Medicaid was ggrowing three and a half
times as fast as Floridafs general revenueh and was gobbling up money needed for
education.
Obama administration officials said they were not
worried by the rumblings among Republican officials in Florida and other states.
Obama aides predicted that all states would eventually
expand Medicaid and set up exchanges when they realized the benefits.
gThe vast majority of states will come in,h Jacob J.
Lew, the White House chief of staff, said Sunday on the ABC News program gThis
Week.h gFor those few that are slow to come in, theyfre going to have to answer
to people why theyfre turning this down and why theyfre letting people go
without coverage.h
Congress required states to expand Medicaid to cover
nonelderly people with incomes less than or equal to 133 percent of the federal
poverty level (up to $25,390 for a family of three). But the Supreme Court said
that the change was optional, and that the federal government could not penalize
recalcitrant states by withholding money they receive under the existing
Medicaid program.
Republicans in Congress are encouraging continued
state opposition to the federal law, which was upheld
last week by the Supreme Court.
A group of Republican lawmakers — 12 senators and 61
House members — said Monday that they had sent a letter to governors urging them
not to set up insurance exchanges.
It now appears that the federal government could be
running the exchanges in one-third to half of all states in 2014, far more than
lawmakers assumed when they passed the law.
Gov. Nikki R. Haley of South Carolina, a Republican,
said Monday that she would not set up an exchange because gstates have little
meaningful flexibility under the Obama administrationfs concept of state-based
exchanges.h
A Texas official welcomed the Supreme Court decision,
saying it provided an opportunity for states to gpush back againsth the
expansion of Medicaid.
gMedicaid already consumes a quarter of the state
budget in Texas, and enrollment and costs would mushroom under the Affordable
Care Act,h said the official, Thomas M. Suehs, the executive commissioner of
health and human services.
Miriam E. Harmatz, a lawyer at Florida Legal Services, said Mr. Scottfs
action was ga terrible decision for our clients, who would have benefited from
the expansion of Medicaid, and a shortsighted decision for the economy of the
state,h which would have benefited from an infusion of federal Medicaid money
into the health care industry.
Bruce Rueben, president of the Florida Hospital Association, said he hoped Mr.
Scott would reconsider and reverse his decision on Medicaid.
Deborah S. Bachrach, a former Medicaid director in New
York, said, gMany states will accept the Medicaid expansion, given that the
federal government is paying all the costs in the short term and most of the
costs in the long term.h