A dramatic showdown over health care funding that’s been unfolding in Florida over the past several weeks reveals the lengths that Republican leaders are willing to go in their quest to remain publicly opposed to Obamacare.
Florida Gov. Rick Scott (R), one of the staunchest opponents of the health care reform law, refuses to accept federal funds to implement Medicaid expansion under the Affordable Care Act, which would extend coverage to about 800,000 low-income people in the state. At the same time, however, Scott wants the Obama administration to give him federal funds to help implement a specific Medicaid pilot program. Ultimately, Scott is demanding money from the government that doesn’t appear to be linked to Obamacare — and he’s willing to go to great lengths to get it.
Scott wants the government to give Florida about $1 billion in federal funds for a Medicaid pilot project — called the Low-Income Pool, or LIP — that helps support hospitals that serve low-income and uninsured patients. LIP is a program that was initiated under the Bush administration to address hospitals’ budget shortfalls from providing too much uncompensated care to uninsured people who can’t pay their bills.
Federal officials are refusing, saying that Scott wouldn’t need LIP funding if he simply expanded the eligibility requirements for the state’s entire Medicaid program. Florida’s LIP program is set to expire at the end of June, and the federal Centers for Medicare and Medicaid Services (CMS) don’t want to renew it. Essentially, the pilot program has become obsolete under the Affordable Care Act, and it doesn’t make sense to fund LIP instead of funding Medicaid expansion.
The whole point of Obamacare’s Medicaid expansion is to cut down on hospitals’ uncompensated care costs by extending insurance to low-income people who otherwise wouldn’t have been able to pay for their care. Indeed, the law is succeeding in this goal so far: Hospitals across the country saved more than $7 billion last year, and the savings were the biggest in the states that agreed to expand Medicaid.
But the governor doesn’t think the federal government should be able to force him to choose Medicaid expansion over LIP. Of course, the distinction is important to Scott because — like many of his fellow Republican governors — he doesn’t want to give the impression that he supports any of the provisions in Obamacare.
So, this week, Scott announced that he plans to sue the federal government for allegedly coercing his state into accepting Obamacare’s Medicaid expansion bu cutting off funds for LIP. “It is appalling that President Obama would cut off federal health care dollars to Florida in an effort to force our state further into Obamacare,” Scott said on Thursday to announce his impending lawsuit. He also compared federal officials to the Sopranos and said they were “bullying” him.
The contentious political fight is currently dividing GOP lawmakers in Florida, many of whom have urged Scott to forget about his grandstanding against Obamacare and simply accept the Medicaid expansion, which would ensure that the state has enough federal funding to cut taxes — a top GOP priority.
Senate President Andy Gardiner (R) told the Tampa Bay Times that it is “difficult to understand” how suing the federal government “will yield a timely resolution to the critical health care challenges facing our state.” The Senate’s budget chief suggested that perhaps Scott is pulling “a political stunt.” Meanwhile, the Koch-backed Americans for Prosperity is pressuring Florida politicians to stand firm against Obamacare.
As the Washington Post’s Greg Sargent points out, one of the great ironies of this scuffle is the fact the Scott is accusing the Obama administration of undermining the safety net for low-income Floridians — while standing firm against the most important health care policy, Medicaid expansion, that could strengthen this very safety net.
On Thursday, Scott said that the Obama administration’s refusal to fund the LIP program was “outrageous” because it “threatens poor families’ access to the safety net health care services they need.” But the LIP program doesn’t actually extend health insurance to those families; it simply compensates hospitals for their care. In order to truly connect poor families to the health care services they need, there’s an easy solution: Scott could accept the federal money to expand Medicaid, which would insure tens of thousands of the working poor.