It's starting to feel like Gov. Rick Scott is suffering from a Don Quixote complex. He spends a lot of time kicking up dust and going into battles with people – the federal government, scientists, his own cabinet – with the notion that he's fighting some noble war to make things better for people. But his efforts often prove to be questionable, at best. If anything, they consume time, energy and resources that could be better used to just get things done.
Case in point: His announcement last week that he's going to "take legal action against Obama" for refusing to commit to giving Florida $1.3 billion to fund the state's Low Income Pool program, which helps hospitals cover the cost of services for uninsured patients who show up in droves in emergency rooms because they don't have coverage and therefore have little access to traditional, less costly healthcare services.--
2014: Year the federal government gave Florida a one-year extension of the Low Income Pool program and a warning that it would expire in 2015
The program was adopted in 2006 by the Bush-Cheney administration, and since then it has helped hospitals help the uninsured, but when the Affordable Care Act was passed, the goal was to keep people out of those hospital emergency rooms by giving them a way to access traditional healthcare, either on the exchanges or via Medicaid expansion. If the Affordable Care Act is implemented the way it's intended, far fewer people will be going to emergency rooms as their primary healthcare outlet – they'll be going to doctors, specialists and clinics. So theoretically, there should be no need to continue to help states fund an inefficient, unfair and unhealthy system.
But that only works if states are willing to partake in the Affordable Care Act by using federal dollars to offer Medicaid to the uninsured. In Florida, approximately 800,000 uninsured people would be covered by Medicaid expansion, and the bulk of the expense would be picked up by the federal government. But Florida has refused to do so, and Gov. Scott obstinately insists that, despite the state's refusal to partake in the new system, the feds should continue to give his administration money to spend however it wants. Because that money helps keep the status quo – and he's banking on it to balance his budget, even though he knew the program was set to expire in June. In fact, he knew it in April 2014, when the feds agreed to expand the program one more year and told the state that it would need to improve its healthcare system so that it could exist without the LIP program. The feds gave Florida one final year of LIP expansion, but made it clear that federal programs to assist with the cost of covering uninsured or low-income individuals would be restructured. It would be up to the state to do its homework to make sure its programs were more efficient and met federal goals if it wanted funding for them.--
2015: Year Gov. Rick Scott created a budget proposal that relied on the Low Income Pool funding to make ends meet
And now, despite the fact that he's practically built his entire administration on refusing to accept federal funding for anything – rail expansion, Medicare expansion – he's insisting that the state must have it. All of it. Now.
"It is appalling that President Obama would cut off federal healthcare dollars to Florida in an effort to force our state further into Obamacare," he said in his announcement last week that he would sue the federal government to force it to continue to fund LIP. He claimed that Florida would not expand Medicaid because he did not want to take part in another program that the federal government could "walk away from," as it's doing with LIP. What he fails to acknowledge, though, is that LIP was never a guaranteed funding source – it was always a conditional, discretionary fund that had to be renewed every several years. Funding for Medicaid, however, is guaranteed by law, is not conditional and will not expire. Apples, meet oranges.--
2017: Year the state Agency for Healthcare Administration has requested Low Income Pool Funding through, despite the fact that the program is scheduled to expire now
Anyway, nobody's super-happy about the governor's decision to sue the federal government – especially not Senate President Andy Gardiner, R-Orlando, who is one of a handful of Republicans in the state attempting to at least come up with some kind of acceptable healthcare expansion plan. Last week, he told the governor that his proposed tax cuts are on hold in the Senate until this mess could be worked out in a way that makes sense. He even reached out to the House to suggest that it's time to find "common ground and present a unified solution that is best for Floridians" when it comes to healthcare expansion.
Oddly, nobody seems to be eager to join him at the table to hash things out. They're probably too busy tilting at windmills.