Florida cuts a deal on Obamacare Medicaid expansion

Florida cuts a deal on Obamacare Medicaid expansion

It’s really tough to say “no” when Uncle Sam shows up at your door with billions in federal money.  Florida Governor Rick Scott came into office as a dedicated opponent of ObamaCare, adamantly stating as recently as June that his state “is not going to expand Medicaid”… but on Wednesday he threw in the towel, as chronicled by the Tampa Bay Times:

Hours after the federal government agreed to grant Florida a conditional waiver to privatize Medicaid statewide, Gov. Rick Scott appears ready to endorse a plan to conditionally expand the health care program to about 1 million Floridians or more.

Scott previously has said that Florida cannot expand Medicaid unless the federal government approves the state’s plan to privatize the system.  Today, he got the waiver he sought.

Scott and other GOP lawmakers have repeatedly warned that Medicaid’s roughly $21 billion annual costs were consuming Florida’s budget and proposed the managed care plan to save money and improve care.

The plan Governor Scott wanted a waiver for doesn’t seem to have been working terribly well so far:

The privatization plan expands on a five-county pilot program that has been rife with problems. Critics worry for-profit providers are scrimping on patient care and denying medical services to increase profits. Some doctors have dropped out of the pilot program, complaining of red tape and that the insurers deny the tests and medicine they prescribe. Patients have complained they struggled to get doctor’s appointments.

Several health plans also dropped out of the pilot program, saying they couldn’t make enough money. Patients complained they were bounced from plan to plan with lapses in care. Nearly half of the 200,000 patients enrolled in the pilot have been dropped from at least one plan, federal health officials noted at one point during negotiations.

Lawmakers say they have fixed the pilot program’s shortcomings, with provisions including increased oversight and more stringent penalties, including fining providers up to $500,000 if they drop out. The measures also increase doctors’ reimbursement rates and limits malpractice lawsuits for Medicaid patients in hopes of increasing doctor participation in the program.

Sounds like it’s in fine shape to handle a million new Medicaid beneficiaries, courtesy of ObamaCare!

The feds are supposed to cover the cost of this Medicaid expansion for the first three years, but then the states begin picking up more and more of the tab, until they reach 10 percent of cost in 2020.  That’s assuming the federal government, which is on course to blow past $20 trillion in accumulated debt by the time Barack Obama leaves office, does not choose to “alter the terms of the deal,” as a particularly imposing government agent once put it to the manager of a certain cloud mining facility in The Empire Strikes Back.

Medicaid serves about 3.3 million people in Florida at the moment, so another million people will be roughly a 30 percent increase.  30 percent of current $21 billion annual cost that is “consuming Florida’s budget” is $6.3 billion.  When the state ends up covering 10 percent of that, it’ll add up to a cool $630 million – probably more, since these figures are unlikely to hold steady through 2020.  Prior to this expansion, Florida had very strict requirements for Medicaid eligibility, but one wonders if Governor Scott’s new high-rolling partners in Washington might have a few more words to say about that, down the line.  And some reports think the number of new beneficiaries from this expansion will be a lot more than the “1 million or more” figure cited by the Times above.  As in, nearly twice as many.

But there was mounting pressure on Scott to take Washington’s money, as the Tampa Bay Times reported earlier today:

A report released by two consumer groups Wednesday makes a pro-business case for Medicaid expansion in Florida, saying the infusion of federal money in the state would create 71,300 jobs and $8.9 billion in economic activity.

Most of those new jobs would be in the health care industry as an estimated 1.8 million people gain coverage through the Medicaid expansion, according to the report from expansion advocates Florida CHAIN and national health consumer organization Families USA. An earlier study done for the Florida Hospital Association estimated that the infusion of federal funds would add 56,000 jobs to the state.

The $8.9 billion figure is a calculation of the money trickling into the economy once people start getting health care. It represents everything from doctors using the revenue to upgrade their facilities to workers needing to take fewer sick days, said Families USA spokesman Bryan Fisher.

Refusing the expansion “would be an act of fiscal malpractice,” said Ron Pollack, executive director of Families USA.

“Every Floridian has a stake in this,” said Laura Goodhue, executive director of Florida CHAIN.

Advocates of the Medicaid expansion also think it will save money from the “cost shifting” losses that occur when hospitals are compelled to provide charity care to the uninsured, although there is considerable dispute over what the net savings will be.  The best-case scenario from the Kaiser Family Foundation estimates $1.3 billion over the next decade.

Governor Scott used to worry that Medicaid costs would balloon faster than the federal government’s projections.  He’d better hope he wasn’t right.

Update: A perceptively depressing point from Twitter correspondent @DrewMTips: What happens to this already huge Medicaid expansion when amnesty for illegal aliens hits?  How about after the prescribed period for the full-boat “path to citizenship” is completed?

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  • http://www.facebook.com/jbagnoli John Bagnoli

    That’s a nice family practice you got there. It’d be a shame if something happened to it.

  • reddarin

    “Lawmakers say they have fixed the pilot program’s shortcomings”

    How exactly does the original plan or the newly ‘fixed’ plan earn the description of ‘privatized’?

  • # MJ1

    Or if you are an ignorant Republican…

  • okieflash

    Governor, you just got bribed and took it…..he is buying out the country with tax payers dollars, and the health care will be broke in a few years, then whatcha gonna do?

  • okieflash

    We have few doctors that accept medicaid now….so who is gonna take care of the medicaid folks for five dollars a visit?

  • JohnGalt

    Still magnitudes of quality better than the thieving Collectivists, who are entirely responsible for this top-down, federal extortion.

  • dondehoff

    Just where is our congress in all of this? The President cannot even get out of bed without funding from the House. There is obviously something massive in the works and it is going to take considerable time, money and research to find out just who is behind all of these NWO/Muslim activivities. It is also obvious many in congress, of both parties, are deeply involved, but surely not all 500-plus house-members and the “Haughty Hundred” in the Senate are part of this conspiracy to change our Republic, Constitutional and freedom form of government.

  • haditinsd

    Most of the troubles in this country are because states fall for these bribes all the time. That FREE money will be the bankrupcy of us all.

  • podunk1


  • jerry1944

    Yes it is easy to take the money till time to pay it back are they take it back and you have all the same bills yourself. Like when banks where handing out credit card to everyone with out knowing anything about them I knew a couple of ppl that got them and used them till they wherent good any more and never paided anything back. They didnt have a job and was on disablilty when they got the cards. But it was easy to use up the 5000 that was on the card

  • http://www.facebook.com/paul.leslie.3998 Paul Leslie

    Scott’s just the latest illustration of what’s wrong with the Republican party. They talk a good fight, but don’t have the spine to actually follow through and stand up to the socialist democrats. As we’ve seen with a host of Republican governors – principles are things you hold on to until the price is right.

  • bleuze

    I understand that governors that do accept Federal Exchanges are screwing their citizens also since now their citizens and be forced to pay the tax (?) if they are not insured! Is this true? If it is, the governors should not be voted in next time since they are NOT watching out for their citzens!

  • http://conservativetimes.org/ Local_Ale

    Allen West was one of four Republicans to vote against defunding Obamacare– (and his constituents punished him for it.) Clearly the Florida GOP likes something about Obamacare.

  • http://conservativetimes.org/ Local_Ale

    West was one of four Republicans to vote against defunding Obamacare–he sold out years about Scott. Coupled with his bizarre claim to read Zimmerman’s mind during L’affaire Tryvonne, he would just be more of the same.

    Anyway, with Anchorbaby Rubio calling for Amnesty, the Florida Republican Party sounds hopeless.

  • Robert Crunk

    This guy reminds me of a piranah! All mouth and no tail!!!I think he’s a good Lib.

  • usluv

    Scott….you have now become an Obama/Davis puppet…loser.

  • http://twitter.com/CarmenMJones1 Carmen M. Jones

    Sounds like it’s in fine shape to handle a million new Medicaid beneficiaries, courtesy of ObamaCare! http://www.Chooseyourjob72dollareveryhouronthelabtop.qr.net/j6IT/75G82-136150BSIiaM430

  • cliff2008

    Hadn’t heard any of that about West. I know the media didn’t protect him. Would appreciate some backup sources.

  • http://conservativetimes.org/ Local_Ale

    Apparently the media did protect West, if you didn’t know his basic history.


  • http://www.davidsmusings.com/ David

    The Republican Party, for all intents and purposes, is dead. There is the Democratic Party and then there is the Democratic Party-lite. And, Gov. Scott, you can kiss your reelection chances goodbye.

  • June W. Gannaway

    Amen, John.

  • http://www.facebook.com/thinmangone Jimmy Cooper

    Hey Cliff why don’t you go drink some of that local_ale Libterd kool-aid, I could smell it as soon as I got close to your Post. We could use more people like Rubio to represent Fl.!!!

  • http://conservativetimes.org/ Local_Ale

    Did you mean more Anchorbabies, or more “new citizens” if Rubio’s Amnesty bill is passed?

  • http://democracylover.blogspot.com Charles D

    LOL, a lot of Democrats think their party is dead and is just a Republican Party-lite.