Florida's Rick Scott's Signs on to Obamacare's Medicaid Expansion

Florida Gov. Rick Scott announced he will accept federal funds to expand Medicaid for three years on Wednesday, after which the law would have to be reauthorized. "I cannot in good conscience deny Floridians to healthcare," he told reporters. The deal was reached, the Tampa Bay Times reports, when he cut a deal with the federal government to privatize the program. The decision adds him to the list of conservative Republican governors to do even though the Supreme Court ruled that states could refuse to go along with the measure to provide health care to the poor without losing existing federal funding. Scott accepted the expansion in exchange for a federal waiver to allow the state to privatize Medicaid, and the decision will expand coverage to about 1 million more Floridians. Pledging to defy Obamacare in all its forms has been a popular stance for Republican governors, including Wisconsin's Scott Walker, Oklahoma's Mary Fallin, North Carolina's Pat McCrory, and Texas's Rick Perry. 

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Ohio's John Kasich and Arizona's Jan Brewer have said they will accept join the policy, which initially is federally funded. Scott's political career was partially based on fighting Obamacare -- he he founded a group called Conservatives for Patients' Rights to oppose the law in 2009, more than a year before he announced he was running for governor. His record is quite conservative: he backed a state law requiring welfare recipients to get drug tests. In June, Scott sid he'd reject the Medicaid expansion.

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So what changed? Mitt Romney lost Florida, and the presidency, in the 2012 election. After that, Scott softened a little, saying, "Just saying 'no' is not an answer" to Obamacare in November. While conservative governors might find the law ideologically offensive, it's hard to resist the cold hard cash the federal government promises with the law. A recent study by expansion advocates said earlier this month that the Medicaid expansion would would create 71,300 jobs in Florida and pump $8.9 billion into the state's economy. (Another study put the new jobs number at 56,000.) Ohio's John Kasich even sounded a little like a bleeding heart in his State of the State address, saying the expansion would free up money to help the needy. "I can’t look at the disabled, I can’t look at the poor, I can’t look at the mentally ill, I can’t look at the addicted and think we ought to ignore them," Kasich said. "For those who live in the shadows of life, for those who are the least among us, I will not accept the fact that the most vulnerable in our state should be ignored. We can help them." Scott, in his announcement Tuesday, talked about his mom, and said, "We also have to be sensitive to the poorest and weakest among us who struggle to afford high-quality health care. ... It is not a white flag of surrender to government health care."

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The Medicaid expansion would cover people making up to 133 percent of the poverty line, or $15,282 for one person in 2013. The expansion is funded by the federal government for the first three years, after that, federal funding drops to 90 percent. When the Supreme Court upheld Obamacare last summer, it ruled that it was unconstitutional for the law to compel states to expand Medicaid or lose federal funds. The Advisory Board Company posts this map of where states stand on the Medicaid expansion:

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Where the States Stand
Where the States Stand