House Speaker Will Weatherford in control of Medicaid decision

Time and dissonance have a way of obscuring the past. We lose track of where an argument began, and which roads led us to this point.

Take expanded health care in Florida.

Today's debate is far removed from where it began months ago, and the testimony of those involved has long since faded from memory.

So, as the state Legislature heads into its final weeks with a solution still nowhere in sight, there is a critical detail that should not be overlooked.

If low-income Floridians are without health coverage at this time next year, they will have Will Weatherford to thank.

The House speaker has occupied a lower-profile role on health care in recent weeks, but it is fair to say no individual has done more to torpedo Medicaid expansion in Florida.

The president and the governor are in favor of expansion. Polls say residents want it, the state's leading health care organizations have lobbied for it, and the Chamber of Commerce has endorsed it. Even the Republican-dominated Senate has proposed an alternative plan that would use federal Medicaid funds.

The sticking point is the Florida House. And the fault is Weatherford's.

Think of how odd that seems in retrospect. At the start of the year, Rick Scott was the hard-core conservative, and Weatherford was the bipartisan breath of air.

And yet it was Weatherford who opened up the legislative session with an inscrutable attack on Medicaid expansion. And it was Weatherford who played to the crowd at the Conservative Political Action Conference in Washington.

And it is Weatherford who has allowed the House to throw up a partisan roadblock to health care for up to a million Floridians.

His concerns are legitimate.

His arguments are weak.

The Pasco County Republican argues the federal government cannot afford to provide health coverage indefinitely to low-income residents. He may be right, and that's one of the reasons Scott's endorsement is not open-ended.

But Weatherford fails to acknowledge that the government is already paying for the medical needs of the nation's poorest residents, and Medicaid expansion is a way to control those costs with preventive care instead of emergency room treatment.

He also fails to acknowledge that safety net hospitals are about to lose their funding. And federal taxes paid by Florida citizens are in danger of being redistributed elsewhere. And the House's bare bones alternative introduced last week will actually cost more per capita, and cover a fraction of the residents.

Weatherford is ignoring reality while riding on his ideological high horse.

Now maybe this was all a ploy to establish his conservative credentials, and he will come around to a more realistic Senate proposal in the coming weeks.

Or maybe he really doesn't see that his position could mean calamity for Florida residents and hospitals, and it will achieve nothing of substance because the federal money he wants to turn down will just be spent elsewhere.

Philosophies are fine, and principles are important. But people are more meaningful than ideals, and this is not an issue in need of a line in the sand.

If health care is not expanded in Florida, it will be Weatherford's call.