1. Opinion

Editorial: Scott takes right step with Medicaid expansion

Published Feb. 22, 2013

Gov. Rick Scott made the right decision by endorsing the expansion of Medicaid that would provide health care to more than 1 million uninsured Floridians, including perhaps 225,000 in Tampa Bay. Give the governor credit for looking beyond his opposition to the Affordable Care Act, negotiating with the Obama administration and making the best decision for this state. Now the Republican-led Legislature should be just as pragmatic, follow the governor's lead and approve the expansion.

The importance of accepting the Medicaid expansion cannot be understated. Florida has roughly 4 million uninsured residents who deserve access to health care, and the cost of treating them is passed on to everyone in higher insurance premiums and hospital bills. Economic studies indicate the Medicaid expansion will create more than 71,000 jobs. The federal government will pay 100 percent of the cost of the expansion for the first three years starting in 2014, then gradually drop to 90 percent by 2020. Florida, which has one of the least generous Medicaid programs, will be one of the states that benefits the most from the expansion and infusion of billions of federal dollars.

Scott withheld his support for the expansion until the Obama administration granted the state two waivers to essentially privatize Medicaid statewide and place all recipients into managed care programs. The key conditional waiver came Wednesday afternoon, and the governor endorsed the Medicaid expansion hours later. The transformation of Medicaid will have to be carefully monitored and managed. A five-county experimental program was not encouraging, with some health plans dropping out of the experiment, patients complaining of poor service and questionable taxpayer savings. Lawmakers say they have fixed some problems, and our hope is it will work better for patients and save more money as it is rolled out statewide with millions of additional patients and many more providers. The rising cost of the existing Medicaid program is unsustainable for Florida taxpayers, and the quickly evolving health care economy is forcing changes throughout.

Now Scott has aligned himself with a half-dozen other Republican governors who have chosen pragmatism over ideological purity in accepting the Medicaid expansion. They include governors such as Jan Brewer of Arizona, John Kasich of Ohio and Susana Martinez of New Mexico. Those are hardly wild-eyed liberals. On the other side are the extremists who remain glued to the Republican fringe such as Texas Gov. Rick Perry, South Carolina Gov. Nikki Haley and Louisana Gov. Bobby Jindal. They are not the future of the Republican Party, and Scott recognizes that Floridians expect a more commonsense approach.

There should be no gloating or partisan sniping about the governor's qualified support of Medicaid expansion from Democrats, which would be counterproductive. The goal is to get the expansion approved by the Legislature, and that will take more work by the governor and lawmakers from both parties to convince Republican leaders it is the responsible approach. House Speaker Will Weatherford, R-Wesley Chapel, and other Republican House leaders remain particularly skeptical, and they have to be persuaded that it would be irresponsible to leave billions of federal dollars on the table and more than a million Floridians uninsured.

Scott embraced the Medicaid expansion after getting what he wanted from Washington, and he still would require state lawmakers to reapprove the expansion after three years. Even with those caveats, the governor will take some heat from the conservative wing of his party that got him elected. But he pleased the moderate middle of the electorate he will need to get re-elected by taking the most positive, forward-looking step of his administration.