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Scott: We Won't Comply With Medicaid Expansion

TALLAHASSEE - (CBSMiami/AP)  —  Gov. Rick Scott now says Florida will do nothing to comply with President Barack Obama's health care overhaul and will not expand its Medicaid program. The announcement is a marked changed after the governor recently said he would follow the law if it were upheld by the U.S. Supreme Court.

"Florida is not going to implement Obamacare. We are not going to expand Medicaid and we're not going to implement exchanges," Scott's spokesman Lane Wright told The Associated Press on Saturday. Wright stressed that the governor would work to make sure the law is repealed.

Scott told Fox News the Medicaid expansion would cost Florida taxpayers $1.9 billion a year, but it's unclear how he arrived at that figure.

Scott said the state will not expand the Medicaid program in order to lower the number of uninsured residents, nor will Florida set up a state-run health exchange, a marketplace where people who need insurance policies could shop for them.

"We care about having a health care safety net for the vulnerable Floridians, but this is an expansion that just doesn't make any sense," he told Fox host Greta Van Susteren on Friday.

Scott has gone back and forth on the issue after the U.S. Supreme Court ruled Thursday that Congress cannot withhold federal Medicaid funding from states that opt out of a requirement in the overhaul to expand coverage to those just above the poverty line.

On the day of the ruling Scott was cautious about the expansion, saying he wanted to read the ruling first. Then during an interview Friday morning on a Jacksonville radio station, Scott said it was unlikely he would go along with the expansion because of the potential cost to the state.

But the governor told the Tampa Bay Times later in the day that he was still evaluating the ruling and would come up with a plan within a few weeks.

Scott was vague when asked in the Fox News interview whether he's been in talks with other Republican governors about how to respond going forward.

"Everyone I've spoken to is doing the same thing," Scott said, but when pressed for specific names, he only referenced what the governors of Louisiana, Texas and Wisconsin have said in the past. His spokesman told AP he could not confirm what conversations Scott has had with other governors on the issue.

Scott, the former CEO of a hospital chain, has been a vocal critic of the health care overhaul from the start. He made his first foray into politics by forming a group called Conservatives for Patients' Rights that ran television ads criticizing the proposal before it was adopted by Congress.

Scott has also complained about the growing cost of Medicaid, the $21 billion safety net program that primarily aids the poor but also picks up nursing home bills for senior citizens. The governor backed a push by the Republican-controlled Legislature to shift Medicaid patients into managed care programs, a move that is still awaiting federal approval.

Scott has rejected federal money in the past, most notably $2.4 billion for high speed rail. His administration has also said no to some money attached to the Affordable Care Act.

But Scott has said yes to money associated with the federal stimulus program and he has changed some of the positions he advocated during his run for governor. Scott also must weigh the politics of saying no to Medicaid because of tight budgets, while it is likely he will continue to push for substantial tax cuts between now and his re-election campaign in 2014.

According to Census data released last year, Florida had the nation's third-highest rate of residents without health insurance during the past three years.

President Obama's health care law called for states in 2014 to expand Medicaid eligibility to those making up to 133 percent of the poverty level, or $29,326 for a family of four. While estimates vary, the Florida Agency for Health Care Administration has concluded that as many as 1.95 million more people would join Medicaid and other state-subsidized health insurance programs over the next five years.

Most of the cost, running into the billions, would be absorbed by the federal government. The Medicaid expansion would not cost the state anything until 2017 — although AHCA estimates that changes to other state-subsidized programs would require state money starting in 2014. AHCA estimates that the overall cost to the state would be $2.4 billion between 2013 and 2018 with the federal government picking up nearly $26 billion.

But other groups analyzing the potential changes contend that state officials have "hyper-inflated" the potential costs because they assume too many people will enroll.

The ultimate choice, however, won't be Scott's alone. It will also be decided by the Legislature.

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