Gov. Rick Scott is poised to deny up to a million Floridians health coverage through Medicaid and invite a federal government takeover of what should be a state-controlled health insurance exchange. His obsessive opposition to President Barack Obama's signature health reform law should not be the final word in Tallahassee, and the state's Republican leadership should rise above partisanship and rigid ideology. The courts have upheld health care reform, the election is over and it is time to do what is best for the state's 4 million uninsured people.
Scott has refused to make moves to implement the Affordable Care Act under the assumption that it would be short-lived. His bet proved to be a bad one. The law withstood Florida's legal challenge before the U.S. Supreme Court and a national election in which it was a centerpiece issue. Even an attempt by the Legislature to put an anti-Obamacare amendment in the state Constitution failed.
Now Florida is about to blow its first big health care deadline. States were supposed to submit blueprints for their health insurance exchanges by Friday, but Health and Human Services Secreaty Kathleen Sebelius said last week that those states that indicate by the deadline that they want to create one will have more time to work out the details. These state-based exchanges are where uninsured Floridians will go to shop for affordable health insurance beginning in 2014.
States are given the option of designing their own exchanges to encourage innovation and address local needs. Scott should be getting on board so the state can better tailor an exchange to fit its needs. If Florida fails to establish an exchange, the federal government will step in instead. But Florida has refused to prepare, and the Scott administration has rejected millions in federal money to assist in planning and implementation.
And there is no sense of urgency among Republican lawmakers, either. Rep. Matt Hudson, R-Naples, a leader on health care issues, says lawmakers don't intend to act until the regular legislative session that begins in March — a timeline that could handicap Florida's ability to create its own health insurance exchange. Incoming House Speaker Will Weatherford, R-Wesley Chapel, sounds reasonable about the need for Florida to control its own exchange, but the clock is ticking.
More disastrous for Florida is Scott's stated rejection of an expansion of Medicaid under the federal law. He doesn't want Florida to participate — an option provided states under the U.S. Supreme Court ruling. But if Scott's position is allowed to stand, about 1 million additional low-income uninsured Floridians who would qualify for Medicaid will be excluded from coverage. And Florida would lose out on an estimated $20 billion in new federal money from 2014 to 2019.
Putting aside the humane benefits of insuring some of the state's poorest adults, Scott should be welcoming the Medicaid money as a boost to economic activity and a greater return of Floridians' federal tax dollars. Those billions would go to the state's doctors and hospitals. It would create jobs and fuel the economy. Isn't that Scott's top priority? And without that money, even Weatherford acknowledges Florida's hospitals would suffer since there still would be plenty of uninsured poor people in the state but a federal supplement to hospitals for charity care would be cut.
The Affordable Care Act is the law of the land and a historic move toward universal care. Scott and Republican lawmakers have to get over their disappointment that their efforts to undo the law failed and get to work ensuring that Floridians gain the most benefit from it.