Internal email messages uncovered by Health News Florida reveal that Gov. Rick Scott (R-FL) is knowingly citing inaccurate cost estimates to justify his refusal to expand Florida’s Medicaid program. Though the governor’s office is fully aware that the numbers are wrong, Scott continues to use them anyway, the documents show.
Florida, which has one of the highest rates of uninsurance in the nation, could extend health coverage to about one million low-income residents by accepting Obamacare’s optional Medicaid expansion. But the governor — an ardent Obamacare opponent — has repeatedly said that expanding Medicaid would just be too expensive, claiming it would cost the state $26 billion over the next 10 years.
As Health News Florida reports, however, that figure from Florida’s Agency for Health Care Administration (AHCA) is inflated because it doesn’t take into account the full amount that the federal government will reimburse states for choosing to expand Medicaid. A more accurate analysis found that expansion would cost the state around $1 billion:
But those numbers are based on a flawed report, state budget analysts say. A series of e-mails obtained by Health News Florida shows the analysts warned Scott’s office the numbers were wrong weeks ago, but he is still using them. […]
The Act says the federal government will pay the lion’s share of the cost for new Medicaid eligibles if a state agrees to expand its program — a decision the Supreme Court left up to the states. The federal contribution for the new eligibles would be 100 percent between 2014 and 2016, then would taper after that to 90 percent by 2020 and stay there.
But the AHCA report assumes the federal match for the new patients would be much lower, about 58 percent. It came up with that by averaging the match amount over the past 20 years. The report doesn’t say why the authors made that assumption. […]
As Health News Florida reported on Dec. 21, the AHCA estimates were huge in comparison to a study released by the Urban Institute and Kaiser Family Foundation, two neutral research groups that specialize in Medicaid studies. Their study estimated that if Florida agreed to expand Medicaid, about 1 million uninsured people would gain coverage at a 10-year cost to the state of around $1 billion.
According to the email chain that Health News Florida obtained, state officials began calling the AHCA’s $26 billion cost estimate into question as early as December 20. One member of the House Health Care Appropriations Subcommittee even pointed out that, since the health reform law specifies that the federal government will help fund Obamacare’s Medicaid expansion, it would actually break Florida state law to expand Medicaid without using the federal dollars mandated for that purpose.
Nevertheless, Scott has continued to repeat his false claim that Florida can’t afford to provide its low-income residents with the health coverage they need. Scott met with U.S. Health and Human Services Secretary Kathleen Sebelius on Monday to express his concerns about what expanding Medicaid would mean for his state’s bottom line. “Growing government, it’s never free,” Scott explained to reporters. “It always costs money.” Just not as much money as Scott says it does.