1. Florida Politics

Gov. Rick Scott backs off support of Medicaid expansion

Gov. Scott’s reversal comes amid stalled talks with the feds.
Published Apr. 7, 2015

TALLAHASSEE — Republican Gov. Rick Scott backed off his support of Medicaid expansion Monday, triggering a political backlash and giving the Florida House ammunition in its ongoing budget battle with the Senate.

Scott, who had thrown his support behind expanding Medicaid two years ago, expressed strong doubts about a government proposal to extend federally subsidized health insurance to nearly 800,000 poor Floridians.

His change of heart comes amid stalled negotiations with the U.S. Centers for Medicare and Medicaid Services (CMS) over $2.2 billion federal-state program known as the Low Income Pool, or LIP, which helps hospitals treat low-income patients.

"We still have several weeks left for budget negotiations," Scott said in a brief statement. "However, given that the federal government said they would not fund the federal LIP program to the level it is funded today, it would be hard to understand how the state could take on even more federal programs that CMS could scale back or walk away from."

Scott's office refused to elaborate on his statement, which was quickly characterized by some media outlets as a "flip-flop" and put the governor in opposition to not just the Florida Senate but a wide range of pro-business and pro-consumer groups.

His statement adds a new dynamic to an ongoing drama as the 2015 legislative session enters its sixth week. It puts the governor in line with the House in a two-against-one faceoff with the Senate at a time when the budget and most major legislation remains unresolved and tethered to the issue of Medicaid expansion.

Both chambers are controlled by Republicans. Unlike the House, however, the more moderate Senate has been insistent on expanding coverage by creating a new state-run marketplace for private health insurance. The Senate has even included $2 billion in federal Medicaid expansion money in its budget proposal.

Responding to Monday's statement, Senate President Andy Gardiner, R-Orlando, pointed out that the Senate shares many of the governor's budget priorities, including tax relief and record education funding.

"However, if our state is forced to make up the difference of $2.2 billion in hospital funding, every area of our budget will be impacted," Gardiner said.

A spokesman for the U.S. Department of Health and Human Services rejected Scott's claim that the federal government could walk away from its obligation to fund Medicaid expansion.

"The law is clear: Federal funding for Florida's Medicaid expansion covers 100 percent of the costs of newly eligible individuals through 2016 and will never fall below 90 percent," agency spokesman Ben Wakana said.

Wakana added that the federal government has "proven itself willing to work with any state interested in expanding Medicaid, and (has) consistently said that a Florida solution would reduce costs for hospitals that are typically passed on to taxpayers and expand access to quality health care for more Floridians."

Medicaid expansion has been a thorny political issue for Scott since 2013, when the federal government first offered Florida $51 billion in tax dollars to provide additional coverage to the poor. Conservatives immediately said the federal Medicaid program was too broken to grow, and linked the proposal to the politically charged Obamacare.

Scott stunned observers in February 2013 when he broke ranks with his base and endorsed expansion.

"Expanding access to Medicaid services for three years is a compassionate, common sense step forward," Scott said in 2013. "It is not the end of our work to improve health care. And it is not a white flag of surrender to government-run health care. I am committed to working every day to improve access to affordable, high-quality health care in Florida, while also protecting taxpayers and keeping our economy growing to create more jobs."

But he never put pressure on House leaders to adopt the policy. And he didn't raise the issue on the campaign trail in 2014.

Scott stopped short of specifically saying he opposed Medicaid expansion in his statement on Monday. Still, his words were quickly described as a "flip-flop" (Talking Points Memo); "walking back" (National Journal); "disgraceful Obamacare reversal" (Salon) and "change in course" (by the Associated Press, which reported it first).

The statement won praise from Americans for Prosperity Florida, an influential conservative group that opposes Medicaid expansion.

"We applaud Gov. Scott for fighting back against over-reaching federal bureaucracies and acknowledging the shortcomings of Medicaid expansion," state director Chris Hudson said Monday. "The governor has shown that he understands the need for both the federal government and Tallahassee to live within their means."

Meanwhile, advocates of expanded coverage, including a bipartisan coalition of individuals and business groups known as A Healthy Florida Works, said they were hopeful Scott would come around.

"The Florida Senate, led by President Andy Gardiner, has put forth a comprehensive, responsible approach to extending health care coverage," spokeswoman Jennifer Fennell said. "We remain optimistic that the Legislature and governor will move forward with this comprehensive plan that protects Florida families and businesses."

Contact Kathleen McGrory at Follow @kmcgrory. Contact Steve Bousquet at Follow @stevebousquet.


  1. The Mar-a-Lago Resort in Palm Beach. JOE RAEDLE  |  Getty Images
    It wasn’t immediately clear how much Mar-a-Lago would charge to host the Marine Corps Birthday Ball — or even if it might do so for free.
  2. In this March 24, 2018, file photo, crowds of people participate in the March for Our Lives rally in support of gun control in San Francisco. JOSH EDELSON  |  AP
    ‘Guns are always a volatile topic in the halls of the legislature,’ one Republican said.
  3. Pasco County school superintendent Kurt Browning says Fortify Florida, the new state-sponsored app that allows students to report potential threats, is "disrupting the education day" because the callers are anonymous, many of the tips are vague and there's no opportunity to get more information from tipsters. "I have an obligation to provide kids with a great education," Browning said. "I cannot do it with this tool, because kids are hiding behind Fortify Florida." JEFFREY SOLOCHEK  |
    Vague and anonymous tips often waste law enforcement’s time and disrupt the school day, says Kurt Browning, president of Florida’s superintendents association.
  4. Tonight's LGBTQ Presidential Forum is hosted by Angelica Ross of FX's Pose. Twitter
    A live stream of the event and what to watch for as 10 candidates meet on stage in Iowa.
  5. In this April 11, 2018, file photo, a high school student uses a vaping device near a school campus in Cambridge, Mass.  [AP Photo | Steven Senne] STEVEN SENNE  |  AP
    "The department does not appear to have the authority to do anything.”
  6. Clearwater Mayor George Cretekos listens to a speaker share an opinion about a city matter during a city council meeting at Clearwater City Hall in Clearwater, Fla. on Thursday, April 20, 2017.  On Thursday, the Clearwater City Council rejected the mayor's resolution urging lawmakers to ban assault weapons.  [Times files] TIMES FILES  |  Tampa Bay Times
    However, the city did pass a resolution calling for more modest gun control measures.
  7. Maurice A. Ferré at his Miami home earlier this year. JOSE A. IGLESIAS  |  Miami Herald
    He served as mayor for 12 years and set the stage for Miami to become an international city.
  8. Rep. Susan Valdes, D-Tampa, during a Feb. 7, 2019, meeting of the House PreK-12 Appropriations subcommittee. [The Florida Channel]
    ‘One test should not determine the rest of your life,’ Rep. Susan Valdes says.
  9. Vice President Joe Biden, right, talks to supporters as former Florida Gov. Charlie Crist, left, stands near during a campaign stop at at Century Village in Boca Raton, Fla., Monday, Oct. 13, 2014. Crist is locked in a tight race against Gov. Rick Scott in one of the most negative gubernatorial campaigns in Florida history. The two disagree on most major issues, including health care, the minimum wage, Cuba policy, gay marriage and medical marijuana. (AP Photo/Alan Diaz) ORG XMIT: FLAD102 ALAN DIAZ  |  AP
    The Florida Republican-turned-Democrat said Biden’s ‘record of getting things done speaks for itself.’
  10. FILE - In this June 20, 2018 photo, immigrant children walk in a line outside the Homestead Temporary Shelter for Unaccompanied Children a former Job Corps site that now houses them in Homestead, Fla.  Migrant children who were separated from their parents at the U.S.-Mexico border last year suffered post-traumatic stress and other serious mental health problems, according to a government watchdog report obtained by The Associated Press Wednesday. The chaotic reunification process only added to their trauma. (AP Photo/Brynn Anderson, File) BRYNN ANDERSON  |  AP
    Since Homestead’s closing on Aug. 3, at least $33,120,000 has been paid to Caliburn, the company contracted by the government to run Homestead.