Fla. agency drops cost of health care overhaul

TALLAHASSEE, Fla. (AP) -- Just two days ago, Florida Gov. Rick Scott was in Washington declaring that the potential cost of the federal health care overhaul to state taxpayers would be as much as $26 billion.

But on Wednesday, Scott's own health care agency released new cost estimates of as little as $3 billion over the next decade.

The startling turnabout is likely to fuel continued criticism that Scott — a longtime critic of President Barack Obama's health care reform — is overstating the numbers to justify his opposition.

The Agency for Health Care Administration drew up the new estimates at the urging of the Florida House. The Scott administration still contends the higher cost is realistic.

The higher figure used by the Scott administration assumed that the federal government would change the law and cut money now pledged to the states, legislative budget analysts said.

Shortly before the agency released the new estimates Wednesday, the budget chief for the Florida House remarked that it was important to base estimates on existing law, not speculation about what would happen to the law in the future.

"This is critical to the integrity of our budgeting process," Rep. Seth McKeel, R-Lakeland, said in a statement.

State economists meet throughout the year to draw up forecasts on everything from sales tax collections to school attendance. The process usually attracts little attention, but the health care overhaul estimates have become politically sensitive because they could impact whether Florida moves ahead with optional parts of the overhaul.

Obama's health care law calls for states in 2014 to expand eligibility of Medicaid to those making up to 133 percent of the poverty level — $29,326 for a family of four in Florida. The changes would also require adding those who are below the poverty level but not eligible for Medicaid, such as childless adults.

The U.S. Supreme Court ruled this summer, however, that expansion of Medicaid is not mandatory and that states can opt out if they choose.

Scott initially declared he would not move ahead with the expansion, but then softened his stance after Obama was re-elected. In a meeting earlier this week with Health and Human Services Secretary Kathleen Sebelius, he cited the $26 billion cost estimate as a potential obstacle.

Internal emails obtained by news organizations this week, however, reflect that the governor's own budget staff had been cautioned about the assumptions underlying their estimates. Democrats have already sharply criticized Scott over his math.

Medicaid is a $21 billion safety net program for the poor in Florida. Currently, the federal government picks up about 58 percent of the annual cost. Most of the Medicaid expansion and other costs of the overhaul are being paid by the federal government.

Scott's health care agency and the governor's office still contend the $26 billion figure is realistic because the federal debt will prompt Congress to change the law and force more of the cost onto states.

McKeel said he agreed that expanding Medicaid could have significant long-term costs and he had no problems with state economists discussing the potential impact of the federal government pulling back its support.

But one health care advocate said the new estimates show the governor is making up numbers to justify his opposition to the overhaul and the expansion of Medicaid.

"When it becomes clear that the numbers and facts don't support the rhetoric, it's apparently OK to go ahead and make up facts and numbers," said Greg Mellowe, policy director for the health care advocacy group Florida CHAIN. "That's an indefensible business practice, especially because it could very well result in irreparable harm to the customers — Florida families and employers."

The new estimates released Wednesday include a bare-bones estimate of $3 billion, but the agency also included additional figures that suggests the cost could also climb to $9 billion if the state decides to pay doctors and other health care providers more. Current federal rules only require the higher reimbursement rate for two years.

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Associated Press writer Kelli Kennedy contributed to this report.

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