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Affordable Care Act

Public Favors Medicaid Expansion as GOP Governors Split

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By a 2 to 1 margin, Floridians favor expanding Medicaid to cover the low-income uninsured, the Times/Herald Bureau reports. About half of those responding to the Florida Hospital Association poll said their support is strong.

Meanwhile, the number of Republican governors who have opted to request the federal funds for Medicaid expansion has grown to six, with announcements this week from Michigan's Rick Snyder and Ohio's John Kasich. 

This increases pressure on Florida's Gov. Rick Scott and New Jersey's Chris Christie, as the Los Angeles Times reports. Christie faces re-election this year and Scott next year, and that complicates their decision.

Here's the conundrum, from Scott's point of view: Saying yes to Medicaid expansion would not only help 1 million or so low-income uninsured people get access to health care, it would bring billions of federal dollars into the state, providing an economic boost.

And as the polls show, voters at large favor it. Hospitals really, strongly favor it because if the money doesn't come in, they will be hurting.

But like Christie, Scott has to mollify the right wing of the Republican Party, which abhors "ObamaCare," as the Times notes. Christie has to guard his flanks for a possible future run for the presidency, and Scott will want to stave off a primary challenge from the right.

Scott can't act, in any event, until the Florida Legislature weighs in. On Monday, the Senate Select Committee on the Patient Protection and Affordable Care Act (PPACA) is scheduled to hear testimony from two consumer activists -- one from the left, one from the right -- and a Georgetown University researcher who studied the impact of expansion on Florida.

The research team reported in November that by expanding Medicaid as the law allows, Florida would be able to cover between 800,000 and 1.3 million of the low-income uninsured at no net cost and would gain $100 million a year.

The Scott administration has been forecasting that the expansion would be too expensive for Florida.  After an initial eye-popping estimate of $26 billion, which Health News Florida reported was based on questionable assumptions,  the Agency for Health Care Administration revised the estimate downward to show Florida would spend $3 billion over 10 years and gain 10 times that much in federal funds.