Scott Explained

By Joe Gruters

Republicans and Conservatives,

Predictably enough, the media is having a heyday with Gov. Rick Scott’s decision to accept three years of federal funding for Medicaid under Obamacare, suggesting flip flops and crass political maneuvering for re-election — moving to the center.

That is their spin. Some conservatives are understandably upset with Scott for not standing against the expansion on principle, feeling like he has betrayed them.

But here is a more full context. Painful as it is to admit, the Affordable Care Act, Obamacare, is the law of the land. With Obama’s re-election and the U.S. Supreme Court decision, the idea of it being overturned is now all but a pipe dream. However, if Republicans can win the White House and Congress, the worst parts may yet be able to be unwound.

And here is the point. The Medicaid expansion is not the worst part of the law. It was an existing program and the expansion is voluntary. Most states, Republican and Democrat, are going to accept the Medicaid expansion because it makes financial sense for the state.

While Obamacare overall remains unpopular — and Scott remains opposed to the law and its intrusive elements — the Medicaid expansion element of it is actually quite popular. It’s very popular in Florida, depending on how the poll question is asked.

About 1.3 million Floridians will get coverage, meaning billions of dollars will flow into the state’s already robust health care economy. That means jobs. Plus, Florida got a waiver it had been seeking to continue privatizing Medicaid for beneficiaries — an important conservative principle.

Is Washington, D.C. totally irresponsible fiscally? Yes. Out of control? Obviously. That question answers itself. But Gov. Scott has no control over destructive, spend-happy politicians in D.C.

Hospitals throughout Florida routinely absorb the costs of providing health care to low-income people not on Medicaid who cannot or do not pay their bills. That drives up costs for everyone else and hurts hospitals financially. According to the hospitals, the Medicaid expansion should alleviate many of those costs while creating new jobs.

Scott has said that much of his opposition to the expansion in the past was based on the federal money running out after three years, and not wanting the state saddled with those expenses. A reasonable caution. But the state has the freedom under the law to back out in three years if the finances don’t work. That might be politically difficult, but if we work hard enough to get Scott re-elected, he will be in Tallahassee to make that call.

Further, because of the Governor’s tough and sometimes unpopular choices in his first two years in office, the state is now looking at a surplus this year — after having billions in deficits the previous years.

Scott does not get much credit in the media for balancing the budget that Gov. Charlie Crist left in shambles. He never will. But we know what he has accomplished with Republicans in the Legislature.

Scott’s own success with fiscally responsible decisions is what makes the Medicaid expansion an option now.

Simply stated: From a state point of view, the positives far outweighed the negatives:

  • billions of dollars flowing into the state;
  • thousands of jobs created;
  • people getting health care that may not have;
  • hospitals getting reimbursements they were not, making them healthier;
  • and an issue taken off the table that Democrats would surely have demagogued.

Gov. Scott has done a terrific job with what he promised to do. Reigning in irresponsible federal spending was not among those promises.

Thanks for being informed and engaged.

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WSJ Blurb – Brief Post for Now

Tuesday’s Wall Street Journal had an interesting little blurb in one of it’s two editorials that I’m going to come back to in an upcoming post, but I figured the blurb was worth posting now.

Medicaid isn’t in trouble because it is badly run, though of course it is. The problem is that it has become so vast and is meant to fill so many political demands that no one can truly control it. Given the Obama Administration’s rigidity, this is not the best reform moment, but unlike his predecessors, Mr. Cuomo seems to recognize that these liabilities can’t be repaired at the margins. The real test will be if he starts to do the politically difficult work of scaling Medicaid down.

My readers will note that their reference to “repaired at the margins” sounds a lot like the “tinkering around the edges” phrase I often use. It all means the same thing. Again, I’ll come back to this editorial in a day or so, but I felt this was worth posting now. The final point of focus, is that Medicaid has simply gotten out of control. As the editorial suggests, this is no time to make marginal changes, to “tinker around the edges”, it’s time for an overhaul. More later.