THE CAPITAL, TALLAHASSEE, July 3, 2012
Margie Menzel, The News Service of Florida
With Gov. Rick Scott vowing that Florida won't expand its health care system for the poor because it will hurt the state's effort to create jobs, his opponents and other advocates charged Monday that the opposite might be true.
A day after announcing that Florida will opt out of the Medicaid expansion envisioned as part of the federal health care law because he fears large long-term costs, Scott repeated on Monday that the new health care law will be a job killer.
"We'll have to raise our taxes," the governor said on CNBC's "Squawk Box" Monday. "Right now you have a choice in Florida government. It's Medicaid, it's education or it's prisons. And Medicaid has been growing at three-and-a-half times our general revenue. So that has made it very difficult to fund our education."
But Senate Democratic Leader Nan Rich, so far the only Democrat running against Scott in 2014, said the health care reform law would create jobs and save the state money.
"Medicaid is jobs," said Rich, D-Weston. "And health care is one of the few areas that didn't suffer job losses during the recession." Spending money – mostly federal dollars – as part of the Medicaid expansion would put more money into a health care industry that has been among the leading growth industries, but has been threatened by cuts from Tallahassee, she said.
Karen Woodall, an advocate at the Florida Center for Fiscal and Economic Policy agreed, saying expanding Medicaid would create 65,000 Florida jobs over five years.
"Medicaid expenditures go to hire people," Woodall said. "They go to pay physicians, nurses, health care workers, CNAs, pharmacists…It defies logic to state that it's a job killer."
Scott on Sunday announced unilaterally that Florida will forgo about $1.9 billion in federal dollars and decline to expand the Medicaid program to cover more people who aren't currently covered.
But some Republican lawmakers have expressed more caution on the issue, and continued to do so Monday.
While the Legislature may not be ready to sign off on Scott's decision –it's not clear whether they'd have any choice because Scott has line item veto power over the budget, and controls the state health care agency that runs Medicaid.
House Speaker-designate Will Weatherford said he hadn't yet spoken with Scott or Senate President-designate Don Gaetz, but predicted the House would take a "rational, deliberative" approach to deciding whether to expand coverage.
"I was no big fan of Obamacare, that's for sure," Weatherford said. "But we also have to recognize that it has been upheld by the court."
Weatherford said he hopes the election in November will relieve Florida of the need to make a decision – Republican Mitt Romney has promised a repeal - "but we can't really count on that," the Wesley Chapel Republican said.
The Affordable Care Act offers full federal funding for expanded Medicaid coverage for the first three years. Then the federal portion shifts to 90 percent, while state contributions rise to 10 percent of costs. But Scott predicted the state will eventually be forced to pay much more than 10 percent.
"Eventually we'll be on the hook for 45 percent of it," he said Monday on CNN.
Florida now pays about 45 percent of the cost of Medicaid, while the federal government pays the balance.
Scott also claimed Sunday that "Florida already has health care safety net programs for those with the greatest need, including assistance for families with incomes up to 133 percent of the poverty line, and Florida KidCare to ensure no child goes without health care in Florida."
Some children's advocates disputed that on Monday, saying that Florida still has half a million uninsured children, ranking it third nationally in that regard. The state currently faces a class-action lawsuit on the grounds that Medicaid children don't get adequate care.
"We still have groups of children that don't receive coverage," Woodall said, but if Medicaid were expanded, that would be ended.
Scott also opposes a second provision of the ACA, the creation of a state health insurance "exchange," aimed at helping the uninsured get coverage, and said the law gives him the flexibility to opt out of doing so. Scott said if that were a good idea the private sector would already be doing it.
Republican legislative leaders, though, say there's plenty of time to decide on the exchanges. Sen. Joe Negron, R-Stuart and his chamber's budget chief for health and human services, said he hopes Congress will "repeal Obamacare and start over from scratch with a better plan…
"But on the exchanges, in the event that Obamacare isn't overturned, the state would have two options," Negron said.
States have the choice of establishing and running the exchanges themselves or deferring to the feds to do so. The deadline is January 2013.
"My general guiding principal is that I prefer state programs over a cookie-cutter federal model, but that's an issue we're going to have to explore," Negron said.
Gaetz said the Legislature is banking on a change of the guard in Washington.
"My plan is to do all I can to elect candidates to Congress and to the presidency who will repeal this bad law," Gaetz said. "I think we've only seen the first chapter. I think the next chapter is what happens when the Congress convenes after the election. I think that's the Plan B."