When the history of President Obama's drive for national health care is written, there will be four moments that will be seen as having cemented the law in place.
First, "conservative" Democrats Ben Nelson and Bart Stupak dropped their objections to Obamacare to get the legislation passed. Next, Chief Justice John Roberts sided with the Supreme Court's liberals in upholding its constitutionality. Then, President Obama won re-election, crushing any feasible path to full repeal.
And Thursday, Florida Gov. Rick Scott endorsed the law's expansion of Medicaid in his state.
Scott's decision is highly symbolic -- and not just because Florida is one of the largest states. A former hospital executive, Scott made a national name for himself during the health care debate by spending as much as $20 million on ads opposing Obamacare through his group, Conservatives for Patients' Rights.
Florida led the 26-state suit challenging not only the constitutionality of the law's requirement that all Americans purchase insurance, but also its provision that coerced states into expanding Medicaid eligibility. For opponents of the law, one of the few silver linings in the June 2012 Supreme Court decision was that it gave states the choice of rejecting the expansion.
Following the decision, Scott warned the law would be "devastating for patients" and "the biggest job-killer ever." He declared: "We're not going to implement Obamacare in Florida."
That was eight months ago. Now Scott says the Sunshine State will accept the federal government's deal to pay 100 percent of the expansion's cost over the next two years after all. He joins such GOP gubernatorial converts as Michigan's Rick Snyder, Ohio's John Kaisch and Arizona's Jan Brewer.
Scott, who is up for re-election in 2014, further cemented this by indicating he would not move to scale back the expansion after the two years are up: "I want to be clear that we will not simply deny new Medicaid recipients health insurance three years from now."
It is not quite a done deal yet. Florida House Speaker Will Weatherford and Attorney General Pam Bondi both announced serious reservations to Scott's decision. But even if the expansion still somehow stalls, Scott's retreat is already resonating in the national debate.
Like other governors who have also accepted this deal, Scott acts as if this is newly found money. But it isn't. It is taxpayer money, much of it from his own state's citizens. Florida would be adding about 1 million beneficiaries to one of the costliest government programs. According to Congressional Budget Office data, that could cost federal taxpayers about $58 billion over the next decade.
Ultimately, Floridians will face a higher burden, too, as the federal government draws down the subsidies. By that time, though, Scott will most likely be retired himself. Paying for this mess will be somebody else's problem.