Former Florida Gov. Jeb Bush (R) appeared on MSNBC’s The Daily Rundown on Tuesday morning to discuss, among other things, a potential presidential run in 2016. And his future political aspirations are already forcing him to choose his words carefully. Even though Bush is an ardent opponent of Obamacare’s Medicaid expansion in private, he wouldn’t go on the record to oppose Gov. Rick Scott’s (R-FL) recent decision to extend health coverage to an estimated 1.3 million low-income Floridians.
Obamacare’s state-level Medicaid expansion is popular with the public, and an increasing number of GOP leaders — including Florida’s — are finally awakening to the reality that accepting federal funds to expand Medicaid is the right move for their constituents as well as for their state budgets. That shift is forcing anti-Obamacare politicians like Bush to mask their opposition to expansion. When host Chuck Todd asked Bush whether he agreed with Scott’s new position on Medicaid expansion, the former governor claimed he’s been too “busy” to form an opinion on the subject:
TODD: Did you think it was the right decision? Would you have made that call?
BUSH: Anytime you have a chance to advocate reform, you should. So Medicaid needs to be reformed. If you’re going to expand it by 50 percent, it sure better be a dramatically different system. And in Florida, there’s a waiver that has been approved that could be that reform — that expands on the reforms that I had a chance to advocate when I was governor. So if the focus is on making Medicaid work for people and that it won’t create this out year costs that people anticipate, that somehow the reform will yield a better result, then okay. Then give him credit. But I haven’t heard that yet –
TODD: You’re not there yet.
BUSH: I guess I’ve been busy, I haven’t been watching the specifics of it. If that’s the case, kudos to the governor. If it isn’t, then he’s put the state in a precarious position three or four years out.
It’s likely not a politically smart move for Florida’s former governor to publicly come out in opposition to extending health coverage to low-income residents in his state, which has one of the highest uninsurance rates in the nation. As of two weeks ago, however, Bush had made up his mind enough to privately pressure Florida lawmakers to oppose expanding Medicaid — urging them to stand in direct opposition to Rick Scott and come up with an alternative to expansion. Those efforts may have paid off. The state’s GOP-controlled House of Representatives voted to reject Medicaid expansion on Monday, effectively stalling reform.
Bush demurred on his personal position on Scott’s decision, but he did indicate his support for Florida’s Medicaid waiver — which is essentially a proposal to shift the program’s beneficiaries toward private managed care. If Bush does begin paying more attention to the specifics of health policy, he may be interested to learn that Florida’s push to privatize the public program would likely be even more expensive than accepting Obamacare’s traditional expansion, since Medicaid is currently much cheaper than private insurance.
The GOP’s potential presidential candidates are split on the issue of Medicaid expansion. New Jersey Gov. Chris Christie agreed to expand Medicaid just last week — a position that may have landed him in hot water with the conservative establishment — but Louisiana Gov. Bobby Jindal remains opposed it, and Wisconsin Gov. Scott Walker has rejected Obamacare’s Medicaid expansion in favor of a risky proposal that may end up providing his state’s poor residents with a lower quality of coverage.
CNN reports that Jeb Bush is cautiously expressing “doubts” about Florida’s Medicaid expansion. “I have doubts because I think if three years from now, as I understand it, three or four years from now, the deal is that the fed match goes from 95 back to what it is now, which is about 55 in Florida,” Bush said.