The PJ Tatler

Gov. Rick Scott Just Billed Us For $58 Billion

Gov. Rick Scott (R-Florida) is the seventh Republican governor that will expand his state’s Medicaid program.  It’s the most expensive provision of Obamacare, but Rick Scott is up for re-election next year.  Michael C. Bender of Bloomberg wrote yesterday that:

Expanding Medicaid under the federal law would add 1.28 million Floridians to the program during the next 10 years, according to a November 2012 report from the Kaiser Commission on Medicaid and the Uninsured, a nonprofit research group.

Scott said he supports a “limited” expansion that would last for three years, while the U.S. pays for the added cost. That’s a reasonable time to judge the expansion and “a compassionate, common-sense step forward,” he said.

“It is not a white flag of surrender to government-run health care,” Scott said. The states split Medicaid costs with the federal government.

Until 2017, the state won’t pay any of the cost of covering people made newly eligible for the program. Thereafter, states don’t have to pay more than 10 percent of the extra cost. The Congressional Budget Office estimates the federal government’s bill for the expansion will be about $638 billion through 2023. The states will pay about $63 billion, according to the CBO.

In the minutes before Scott’s announcement, Tea Party organizers urged activists to call and e-mail the governor’s office asking him to oppose expanding Medicaid.

“He’s worried about his re-election,” Slade O’Brien, Florida director for the Arlington, Virginia-based American’s for Prosperity, said by e-mail. “We can’t let Governor Scott put personal political ambition ahead of principled conservatism and what’s right for Florida taxpayers.”

Philip Klein at the Washington Examiner had slightly different numbers.

 Florida would be adding about 1 million beneficiaries to one of the costliest government programs. After the Supreme Court decision, the Congressional Budget Office estimated that adding 11 million people to Medicaid would cost $643 billion over the next decade — meaning a back of the envelope estimate is that Scott’s decision could ultimately cost federal taxpayers about $58 billion over the next decade.

Klein also took issue with Scott’s three-year sunset provision.

In practice, however, this sunset idea is incoherent. Scott is up for reelection in 2014, and no matter who is in office, it’s doubtful that after three years of allowing broader Medicaid eligibility, that the state would suddenly kick people off the program or prevent new Floridians from enrolling under eligibility standards that have prevailed for three years. Even Scott seems to acknowledge this by saying, “I want to be clear that we will not simply deny new Medicaid recipients health insurance three years from now.”  Realistically, this was Scott’s one and only chance to resist the Medicaid expansion, and he folded.

Scott’s proposal still has to pass through through the Florida legislature to become law. But in the meantime, he has become the seventh GOP governor to embrace the Medicaid expansion. The higher the number of states that agree to expand Medicaid, the more compelling the logic becomes for wavering governors to decide that they, too, must get their fair share. So Scott’s decision will likely lead to a further expansion of the program in other states.

So, with Republican Governors Jan Brewer of Arizona, Rick Snyder of Michigan, John Kasich of Ohio, Susana Martinez of New Mexico, Brian Sandoval of Nevada, and Jack Dalrymple of North Dakota, I wonder who will cave next on the Medicaid provision?