Quote of the Week: “As far as I’m aware, the governor doesn’t have a contingency plan, and that’s really not surprising considering Republicans have really had their head in the sand on this issue for so long. People are dying as a result of our inaction.” – Democratic House minority leader Mark Pafford, D-West Palm Beach
So, let's just say you're one of the most unlikable governors in the United States of America, and even after you cheered on a lawsuit against President Obama's Affordable Care Act, you turned on a dime to say that you sort of supported some of it – specifically the Medicaid expansion piece – because you used to be poor, too. It's almost like you're human and you get it, right?
Not necessarily. Last year, Gov. Rick Scott about-faced on his about face, reneging on his perceived efforts to expand Medicaid. Instead, he wandered back into the same conservative swamp that claims the hearts and minds of so many Republican officials who are entitled but hate "entitlements." The $51 billion in federal funds that was to be used to expand Medicaid and save the lives of nearly one million people wasn't quite enough to buy his allegiance to the Affordable Care Act, because he was too busy buying the votes of the idiot base. Champers for everyone who doesn't need free champagne, but may be in need of medical treatment!
18 million: Population of Florida
What do you do with your two faces now? Well, on March 4, Gov. Scott decided to send a missive straight to President Obama, this time playing chicken on the issue of the federal government's $2 billion backing of the state's Low Income Pool funding, which is set to expire in June. Traditionally, LIP funds are used to help hospitals offset the cost of caring for the uninsured, but the program is being restructured, according to the Centers for Medicare and Medicaid Services. Florida's LIP program, the feds say, will not continue in its current form, but the state has yet to participate in the Patient Protection and Affordable Care Act, under which the program will be restructured, so the future of its funding is unclear. But Scott isn't hearing it, and he's even built the $2 billion into his proposed state budget. So, even after turning down $51 billion in Medicaid funds to help care for the uninsured, he's demanding that the federal government continue to subsidize the program he wants, in the way he wants it.
"This request is not associated with Medicaid expansion in any way and your administration has already made it clear that whether or not a state expands Medicaid does not impact the continuation of similar programs within that state," he writes. "California, for example, has expanded Medicaid and their supplement funding continues at more than $5 billion a year. Texas, by contrast, has not expanded Medicaid and their supplemental funding continues at nearly $7.5 billion a year. As was noted in the independent evaluation of Florida's Medicaid program that the federal government required for this year, 'When considering the total population that Medicaid funding will cover, California and Texas are both receiving substantially more supplemental funding than Florida.'"
1.6 million: Number of Floridians who have already enrolled in the Affordable Care Act's federally controlled health-insurance exchange
If Obama doesn't play along? Well, Scott just won't provide any additional money to help care for the indigent, and it'll be all Obama's fault. So there!
"Should your administration decline to accept a new LIP model and therefore terminate this program, I will not support using any state funds to backfill this federal program," Scott writes. "Florida taxpayers fund our federal government and deserve to get a return on their investment. Moreover, we have worked hard to turn Florida's economy around and cannot afford to fund programs started by the federal government."
$2 billion: Amount that the state of Florida stands to lose in June when the federal funding of the Low Income Pool expires
The argument comes at a key time in the evolution of the nation's healthcare system. The pending King v. Burwell case in the U.S. Supreme Court (oral arguments were held on March 4), which is trying to undermine the funding system for federal health care exchanges under the ACA, could have huge effects on Florida. If it succeeds, 1.6 million of the state's residents would be on the hook for larger private insurance costs. Federal funding would stop.
Florida's refusal to form its own marketplace is like the new Coke. Conservatives are trying to read into the law that federal funding is not allowed in states that didn't make their own health care markets or expand their Medicaid programs. Backlash! Smells like 2016, doesn't it? Or is that a waft of 2012?