The Medicaid Expansion Drama Takes Bizarre Turns in Florida

It sounds bizarre, but it involves Florida and Arizona politics, so it's par for the course.

It is January 2013 and a group of Republican governors have all worked against unions, women's rights, Planned Parenthood and the Affordable Care Act (ACA). But most of all, especially after the Supreme Court ruled the ACA constitutional, they opposed Medicaid expansion.

At the front of this anti-populist gang of executive officers is our Florida Gov. Rick Scott. It was Florida's attorneys general in both the Charlie Crist administration before him and his current administration that led the charge against "Obamacare."

The Republican Party was getting desperate to block implementation of the law, including tagging the ACA as Obamacare.

Changing the name worked in the 1950s when Harry Truman tried to develop a Federal Health Care policy, and it failed partly because a PR firm recommended that the opposition party call it "Socialized Medicine." That struck fear in the hearts of Americans who feared that socialism would dominate America.

But it didn't work this time.

Obamacare and Medicaid expansion were being accepted in state after state. And in February Scott stunned the other obstructionist governors when he announced that he was now in favor of the expansion in his state, calling it "unconscionable" if we did not go forward with one of the seminal parts of Obamacare.

His move to endorse the expansion makes more sense when you consider that Scott came from the world of managed care. He also had declared that a state should be run more like a business and had just gotten a waiver to put more Medicaid users into mandatory Managed Care Organizations (MCO), many of which were run by old colleagues.

Scott's switch gave hope to 1.2 million Floridians who would finally get coverage and not have to fear the harsh economic consequences if they tried to go to a doctor outside of an emergency room.

So select committees were assigned to investigate the possibility of moving forward with Scott's wishes.

They heard testimony from citizens (including myself) who gave a human case for the expansion. Hospitals, academics and even business lobbyists said it made financial sense.
But what seemed to catch the attention of the conservative committee members was the testimony of a gentleman who gave a bleak picture of Arizona's ill-fated attempt at its own Medicaid expansion.

Tarren Bragdon, president & CEO of the Foundation for Government Accountability, completed his testimony by stressing that Arizona would never give in to the federal government's attempt to make the expansion a reality in that state.

Forget the fact that he said that testing welfare recipients for drugs was warranted, even though the tests came out 97 percent negative. He claimed that the testing scared away drug-using applicants.

The most amazing thing about his testimony was that, despite his bleak picture of Arizona almost going broke funding the program, Gov. Jan Brewer threatened to veto every bill, including the budget, if legislators did not move forward with it.

She pressured both sides of the aisle until they agreed to the state-sponsored expansion.
This is the Jan Brewer who was taking people off transplant lists to fix the state budget. This is the Jan Brewer who practically put her finger up the president's nose on the tarmac when he came to visit her. The very same Jan Brewer who supported a bill that declared that all Hispanics be considered undocumented until proven otherwise.

Granted, Arizona is not Florida. They worked to cover only 300,000 uninsured citizens. Florida has 1.2 million. Yet the select committees pointed to Arizona's testimony over the guidance offered by Florida citizens, hospitals, academics and business people, who urged them to expand Medicaid.

When the session closed without any action on the matter, Scott did nothing.

He could have vetoed the budget, as Brewer had threatened, but he didn't. Instead, he vetoed funds to help build a housing development for the homeless in Pasco.

In the meantime, Medicaid expansion is in a coma in Florida. Poor people continue to flock to emergency rooms, costing hospitals enormous amounts of money.

The billions of dollars offered by the federal government to pay for the plan will go elsewhere, as will the jobs the expansion would have created.

Is that how you run a business, governor?

This article was originally posted in the new commentary and news e-magazine, Context Florida.