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Scott to Look at Other Medicaid Cost Estimates

Gov. Rick Scott is willing to look at estimates on the cost of Medicaid expansion other than the ones he has been using, according to a release  Tuesday evening.  

The statement from Scott's Communications Director Melissa Sellers came in apparent reaction to Health News Florida’s reportearly Tuesday headlined “Legislative Analysts told Scott His Medicaid Estimates Are Wrong (But He’s Using Them Anyway).”

That report, based on a series of e-mails among state officials, was picked up by numerous other publications, including the Associated Press.  PolitiFactlooked at the source of Scott’s numbers and found it so flawed it ruled Scott’s statements “false.” And some public officials, including U.S. Rep. Kathy Castor, D-Tampa, issued statements critical of the governor.

In several public statements, Scott has cited $26 billion as the 10-year cost of Medicaid expansion, saying he got it from the Agency for Health Care Administration. AHCA estimated the total state and federal 10-year cost at $63 billion.

AHCA is part of the executive branch and its chief, Liz Dudek, reports to Scott. 

The state’s chief economist Amy Baker and Eric Pridgeon, a House budget analyst, sent e-mails to AHCA and Scott’s staff Dec. 20 advising that the estimates could not be used because they’re based on a flawed assumption. AHCA assumed that the federal government would not come through with the money promised under the Affordable Care Act to states that expand Medicaid.

Baker and Pridgeon asked AHCA to correct the assumptions and re-do the estimates. That work, by Medicaid Finance Bureau Chief Tom Wallace and his staff, is reportedly under way.

Last Friday, Scott’s health policy and budget staffer Mike Anway sent an e-mail to Baker saying he wants to present the AHCA numbers as an alternative estimate to whatever AHCA comes up with. Anway said he believes the AHCA estimates because he doesn’t trust the federal government to come through with the money.

Tuesday evening, after a day of criticism provoked by the article, Scott spokeswoman Sellers released this statement:

“The discussion underway now about the cost of adding people in Medicaid under the new healthcare law is incredibly important.  Gov. Scott is focused on improving the cost, quality and access of healthcare for Florida families. When he met with (Health and Human Services Secretary) Sebelius yesterday in Washington, they discussed the AHCA cost estimate report and the Governor’s concerns about how taxpayers could afford to nearly double the number of people in Medicaid.

“AHCA’s report concluded that adding people to Medicaid under the new law would cost Florida $26 billion over 10 years. Others have asked AHCA to use different assumptions to calculate different cost estimates. We look forward to reviewing those cost estimates as well.

“There are three things the Governor has stressed that remain unchanging in this important discussion about cost estimates. First, growing government is never free. Second, the number of people in Medicaid would nearly double with the new law (from approximately 3.3 million today to over 6 million). And third, once government grows, it is almost never undone. The fiscal cliff debate in Washington is proof enough of that. Additionally, as the AHCA report points out, federal projections on growing government have a long history of being much lower than actual costs.

“Beyond understanding the cost of adding people in Medicaid, the Governor believes it is important that any healthcare decision improve the quality of services available to Floridians at a cost they can afford.”

Shortly before the Scott statement came out, Rep. Castor released one saying she was “outraged” when she read the information in the Health News Florida report. She obtained the e-mails that the article was based on to review them herself.

“Not only did Gov. Scott manufacture flawed cost estimates, but it appears he had been advised that the numbers were flawed and used them anyway,” Castor said. “Florida Legislative Appropriations staff advised the governor's office that the numbers were misleading, but it appears that the governor ignored it." 

“Clearly this was not a mistake,” Castor said in the statement. “Knowing that the numbers are wrong and using them anyway is.”

--Health News Florida, journalism for a healthy state, is a service of WUSF Public Media. Contact Editor Carol Gentry at 813-974-8629 or 727-410-3266, or at

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.