The number of governors refusing to accept the federal offer of hundreds of millions of dollars for expanding Medicaid to their state’s working poor is dwindling, with Florida Gov. Rick Scott last Wednesday joining Ohio’s Gov. John Kasich and Michigan’s Rick Snyder in accepting the offer.
More than two dozen governors continue to hold out against federal Medicaid expansion efforts. However, as the calendar moves toward implementation of the Affordable Care Act in 2014, some governors are dropping objections and signing on.
In addition to Scott, Snyder and Kasich, Republican governors of Arizona, Nevada, New Mexico and North Dakota have previously said they would expand the program.
Florida newspapers are describing Scott’s action as a “stunning about-face for a small-government Republican who was one of the loudest voices in an aggressive and ultimately unsuccessful, legal strategy to kill a law he derided as “Obamacare.”
In Mississippi, meanwhile, Gov. Phil Bryant continues to hold out, insisting accepting the Medicaid expansion to add 300,000 working poor to Medicaid could ultimately bust the state’s already-strained budget. He has conceded, however, that the Affordable Care Act regardless of whether Medicaid is expanded will greatly increase the state’s Medicaid rolls.
This, he says, is because more of the state’s uninsured poor will sign up as a way to meet the federal mandate that everyone have some sort of medical insurance. Where the state will get the tens of millions of dollars to handle what Mississippi officials call “the woodwork effect’ is uncertain.
At the Capitol, the fight over the expansion has created the expected partisan divide, with Republican legislators aligning with Bryant’s hard-line refusal of expanded coverage. For their part, Democrats have held up a July 1 reauthorization of state Medicaid funding in hopes of forcing a vote on the Medicaid expansion. But as the minority in both houses, Democrats may eventually have to cave or risk cutting Medicaid coverage for hundreds of thousands of Mississippi’s poor, disabled and elderly.
Florida’s Gov. Scott forced some concessions out of the feds in agreeing to the Medicaid expansion. The former health care executive gained approval to give a try-out to privatizing Medicaid and got permission to bow out of the Medicaid expansion in three years, when the federal share goes from 100 percent to 90 percent.
Skeptics say Scott — who has low favorability among Florida voters — is merely trying to boost his 2014 re-election chances.
“It’s just a self-serving political move,” said one Democratic strategist.
Harsher criticisms are coming from what were once (and may still be) political allies of Scott, narrowly elected in 2010 on the strength of the Tea Party vote.
Said one conservative critic of the governor’s capitulation: “Rick Scott is the Benedict Arnold to the Tea Party and Patriot movement.”
Scott, in making his announcement last Wednesday, was careful to point out that the Republican-controlled Florida Legislature will ultimately decide whether his proposal is worth implementing. That is far from certain, particularly in the more partisan House, the Miami Herald reports.
The same could be said for Mississippi. Should Bryant try to seek a three-year arrangement with the feds, he would still have to convince the GOP-controlled Legislature to take the deal. At this point, that could be difficult to do considering the non-stop criticism from Bryant of the Medicaid expansion proposals.