Sometimes Gov. Rick Scott likes federal healthcare dollars, but other times he doesn’t.
The Florida Republican is back to opposing Medicaid expansion after appearing to support it for the last two years. As he refuses to accept the billions of federal dollars it would bring his state, he’s suing the Obama administration for threatening to halt a different supply of federal funds to cover the costs of the uninsured.
And while Scott has built his political career largely around opposing government initiatives laid out in the Affordable Care Act, he made millions as an executive of a for-profit hospital network that admitted to fraudulently billing Medicare.
Scott is admittedly not the only Republican with a divided response to federal health programs. While the GOP still opposes the 2010 healthcare law in general, some Republicans have accepted its Medicaid expansion and just about all of them staunchly defend Medicare, the popular government insurance program for the elderly.
But of all the Republican governors, Scott has been perhaps the most vocally antagonistic against the healthcare law — and so his recent tactics have befuddled his conservative supporters.
“I think it would be a boldfaced lie for anyone on the Right, Left or middle to say what he’s thinking,” said Chris Hudson, director of Americans for Prosperity’s Florida chapter.
Even before Congress passed the healthcare law in 2010, Scott was out front opposing it. He founded a group expressly for that purpose — dubbing it Conservatives for Patients’ Rights — and used that platform to run ads against the reforms Democrats were discussing and urged moderates to support conservative ideas instead.
After the law was passed, he fueled his first bid for governor by advocating for the law’s repeal. And when the Supreme Court gave states an opt-out from the law’s Medicaid expansion, Scott was the first governor to claim it. Nearly half the states have followed suit.
So it came as a surprise to many when he announced two years ago that he’d support expanding Medicaid for a limited period of time, although he was facing a re-election challenge at the time.
“I cannot, in good conscience, deny the uninsured access to care,” Scott said at the time, even though he’d previously called the law “devastating” for patients and taxpayers.
The Florida legislation ended up rejecting expansion. But now, as legislators wrestle over whether to pass an alternative expansion plan, Scott has now reversed course again. That’s a relief to conservatives, but it still leaves them scratching their heads over why he once supported it.
“I think the most likely explanation for his first change of position was that he saw it would benefit him politically,” said Michael Cannon, director of health policy studies for the Cato Institute.
There’s one potential explanation they point to: Had Florida expanded Medicaid two years ago, the federal government would have paid for all of it. But the federal match will drop to 95 percent after 2016, requiring the state to kick in a small portion of the funding.
Indeed, when Scott agreed to Medicaid expansion he limited it to just three years initially.
“I think that a lot of people are surprised and view it as a flip flop, but it’s really not as much of a change as it first appears,” said Tarren Bragdon, director of the Naples-based Foundation for Government Accountability.
Bragdon flew around the country with Scott back in 2009 to help make his case against Democrat-led health reform. His group has opposed Medicaid expansion all along, but Bragdon still gives Scott something of a pass on that account.
“If we could get something without a direct imposition on the state, why leave that money on the table?” he said. “Now that period of time has passed. So I think in Gov. Scott’s mind that requires a different kind of calculus.”
Scott’s reversal on Medicaid has made him even more vulnerable to charges by Democrats that he’s not approaching the healthcare law with citizens’ best interests in mind, but rather to further his political ambitions.
“It is 100 percent political and calculating,” said Max Steele, a spokesman for the Florida Democratic Party. “He has aspirations for higher office. If he’s facing a primary, he wants to be the biggest Obamacare villain there is.”
But others who know Scott personally defend his approach. Kirt Anderson worked with him nearly a decade ago to found Naples Community Church, where Scott and his wife now periodically attend.
Anderson, who serves as pastor there, said he doesn’t talk with Scott about his policy decisions. But when Scott announced he’d support Medicaid expansion, Anderson says he believes it stemmed from concern for the poor.
“What was ringing in my head was things he had said previously about concern for the poor,” Anderson said. He doesn’t know why Scott is opposing it now but says he knows “there’s a good reason for that.”
“I just don’t know what it is,” he said.
