WASHINGTON — The White House has a Medicaid expansion argument for Gov. Rick Scott and Florida Republicans: It creates jobs.
A state-by-state report released Wednesday estimates Florida will lose out on 63,000 new jobs, mainly in health care, from 2014 to 2017. That's the three years the federal government would have paid the entire cost of providing health care to 848,000 people.
The study by the Council of Economic Advisers — titled "Missed Opportunities" — is part of an ongoing push by the Obama administration on a central part of the Affordable Care Act.
But change is not expected in Tallahassee. Incoming Senate President Andy Gardiner said he still supports a Medicaid expansion alternative his chamber developed, but there is little room to negotiate with counterparts in the House.
"Unfortunately, the federal government in their mandate is all or nothing," said Gardiner, R-Orlando. "I think that's one of the things that adds to the challenge."
The report relies on various studies, including one that looked at a Medicaid lottery in Oregon in which some people got coverage and others did not. It makes a number of other claims evaluating states that have expanded and 24 others that have not. It says, for instance, that with Medicaid expansion, 38,000 fewer Floridians would see "catastrophic out-of-pocket costs in a typical year." It estimates that about 35,000 women would have gotten a mammogram in the past year and more than 52,000 would have gotten a Pap smear.
President Barack Obama said in a statement: "I applaud the governors and state legislatures of both parties who have done the right thing and expanded Medicaid in their states, and I urge the governors and state legislatures who have not yet expanded Medicaid to put their constituents' health over partisan politics and give millions more Americans the access to affordable health care they deserve."
Scott, who emerged from obscurity in opposition to Obama's health care law, initially rejected the Medicaid expansion but reversed course in February 2013. "While the federal government is committed to pay 100 percent of the cost, I cannot, in good conscience, deny Floridians the needed access to health care," Scott said, talking about helping the "poorest and weakest."
Federal money has enticed the Florida GOP before — the stimulus bailed out the state budget during the recession — but Republican objections to the health care law have been intense in the more conservative House. Scott was criticized for not pushing enough.
Outgoing House Speaker Will Weatherford led the opposition even as state Senate leaders formed a plan to use $50 billion in federal dollars over a decade to allow people to purchase private coverage. Weatherford on Wednesday said that "based on the disastrous rollout of Obamacare, the lack of information on the federal budget impact and the ever-changing rules and regulations, I am skeptical of the job creation numbers generated by the president's office."
The jobs argument is not new, and estimates have varied. A Florida Hospital Association study last year said nearly 122,000 permanent jobs could be created over a decade with $51 billion in federal funds to the state. Former President Bill Clinton in a speech to Democrats in South Florida last week cited 78,000 jobs.
But top Florida Republicans say the state could be on the hook for billions in additional health care spending.
"We can have a legitimate discussion about priorities and the fiscally responsible way to handle this," White House press secretary Josh Earnest said in an interview. "But what is difficult for Republicans to explain is why they would block legislation that would expand access to health care for hundreds of thousands of Florida residents when it wouldn't cost the state a single dime, at least for the next three years."
Charlie Crist, the top Democratic candidate trying to unseat Scott, seized on the report and said Scott was costing the state jobs. Scott's campaign replied with a statement about the more than 800,000 jobs Florida lost during the economic downturn that happened while Crist was governor. "Charlie Crist is the last person who should be talking about jobs," said spokeswoman Jackie Schutz, boasting of job growth under the current governor.
The Scott campaign did not address the subject of the White House report.
Times/Herald staff writer Tia Mitchell contributed to this report.