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Florida governor, a health reform foe, expands Medicaid

Florida governor Rick Scott, one of the biggest critics of President Obama’s health reform efforts, said Wednesday he would do the administration’s bidding and expand the Medicaid program.

But Scott said he was doing the expansion on his own terms: for three years only, while the federal government is footing the entire bill.

“While the federal government is committed to paying 100 percent of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care,” Scott said in a news conference.

“We will support a three-year expansion of our Medicaid program under the new health care law, as long as the federal government meets their commitment to pay 100 percent of the cost during this time. This legislation would sunset after three years and need to be reauthorized.”

Scott denied he was giving in to the administration. “It is not a white flag of surrender to government-run health care,” he said.

The 2010 Affordable Care Act was designed to transform health care in the United States, which most experts agree currently costs too much and leaves far too many people without health insurance. It was meant to provide more care to people who can’t buy insurance by forcing states to expand Medicaid.

The hope was to add about 16 million of the poorest people to the rolls -- about half of those who need health insurance. But after a series of challenges to the law, the U.S. Supreme Court ruled in June that the Medicaid expansion requirement went too far. While most of the Affordable Care Act was constitutional, the court ruled, the federal government could not force states to offer Medicaid to more people.

The Congressional Budget Office projects that 12 million people will become newly eligible for Medicaid in the states that choose to expand their offerings by 2022. The law required states to extend Medicaid to people earning up to 133 percent of the federal poverty level, or about $14,800 for single people and $31,000 for a family of four.

Many Republican governors immediately said they wouldn’t expand Medicaid.

Texas governor Rick Perry turned down $76 billion in federal matching funds that would have helped pay to do it over the first five years. “We’re just not going to be a part of … socializing health care in the state of Texas,” Perry told reporters in July.

South Carolina’s Nikki Haley said expanding Medicaid would bring people out who were already qualified -- and she said that her state would go broke taking care of them, even if the federal government paid the bill for those who would newly qualify. In addition, states will have to start paying a very small percentage in 2017.

But health care experts predicted that many red states would not turn away free money from the federal government.

Arizona governor Jan Brewer said her state would expand Medicaid to about 300,000 residents in her state of the state address last month. Michigan governor Rick Snyder made his announcement Feb. 6: His state will add about 320,000 people to the joint state-federal health insurance plan for the low-income.

“I am forced to accept it as today’s reality and I have decided to expand Nevada’s Medicaid coverage,” Nevada governor Brian Sandoval, another Republican,  said in December.

Republican-leaning holdouts include Alabama, Louisiana, Idaho, Mississippi, South Carolina, Maine and 12 others.

Scott said he wasn’t happy, but said he was facing reality.

“There are no perfect options. Our options are either having Floridians pay to fund this program in other states while denying health care to our citizens or using federal funding to help some of the poorest in our state with the Medicaid program as we explore other health care reforms,” he said.

Left-leaning groups applauded.

“Now about 613,000 Florida women stand to gain the security of quality health coverage and the ability to get the care they need, when they need it, without facing huge medical bills,” said Judy Waxman of the National Women’s Law Center.

“Combined with other reforms in the Affordable Care Act, this expansion would reduce the percentage of uninsured women in Florida from 25.3 percent to 5.8 percent.”

Scott says he’s not against health reform, he just doesn’t like the approach taken in the 2010 health reform law.

“Before I ever dreamed of standing here today as Governor of this great state, I was a strong advocate for better ways to improve health care than the government-run approach taken in the President’s health care law,” he added.

“I believe in a different approach. But, regardless of what I -- or anyone else -- believes, a Supreme Court decision and a presidential election made the President’s health care mandates the law of the land.”

Scott says he will still refuse to set up a state health insurance exchange, leaving the federal government to run it.

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