I hope you’ll indulge this blog for writing about the bruising, high-stakes fight over the Medicaid expansion in Florida for a second day in a row. But now things have taken a turn towards the truly surreal.
As you may recall, Governor Rick Scott recently reversed himself on the Medicaid expansion, digging in against it so hard that his fellow Republicans warned that he was putting the push for tax cuts, a major GOP priority, in serious peril. (This is because the Obama administration is considering phasing out funding for another Medicaid program — the Low Income Pool, or LIP, which provides money to hospitals that treat the uninsured — and without that money, or the Medicaid expansion money, the budget is in trouble. State Senate Republicans want him to take the expansion money; he, and state House Republicans, are saying No, and conservative groups such as the Koch-funded Americans for Prosperity are demanding no surrender.)
Now Scott is taking a new step: He is suing the Obama administration as part of that dispute. Basically, Scott’s lawsuit is designed to get the administration to fork over federal money for health care — but only if it is not part of Obamacare.
The Tampa Bay Times reports:
Republican Gov. Rick Scott plans to sue the federal government for allegedly coercing Florida to expand Medicaid, his office said Thursday.
“It is appalling that President (Barack) Obama would cut off federal health care dollars to Florida in an effort to force our state further into Obamacare,” Scott said in a statement….
Scott said the action violated a U.S. Supreme Court ruling “that the president cannot force Medicaid expansion on states.”
“Not only does President Obama’s end to LIP funding in Florida violate the law by crossing the line into a coercion tactic for Obamacare, it also threatens poor families’ access to the safety net health care services they need,” Scott said.
The lawsuit comes in response to a letter the federal government sent to the Scott administration earlier this week, reiterating that it is looking to end the LIP program, due to a number of problems the feds see with it. The feds reiterated that the best way for the state to pay for health care for low-income people is by accepting the Medicaid expansion, which could cover at least 800,000 Floridians.
Scott is demanding that the federal government continue the LIP program, and is professing outrage that the feds may withdraw funding that would give “poor families access to the safety net health care services they need.” But he won’t accept the Medicaid expansion money that might accomplish that goal more effectively: LIP money does not give people insurance; it largely pays hospitals for care sought by people who can’t pay for it. Scott claims the feds might not make good on their promise to fund the Medicaid expansion, but Scott previously backed the expansion, and state Senate Republicans say their proposal to expand Medicaid would explicitly end the program if the feds reneged.
(In fairness, even if Scott wanted the Medicaid expansion money, he might not be able to persuade state House Republicans to accept it. But he, too, has in fact personally dug in against it.)
Now Scott is arguing that the federal government is trying to coerce Florida into accepting federal money to pay for health care via the Medicaid expansion, by denying it federal money to pay for health care via LIP. The basis for the coercion argument is that the feds’ letter links the Medicaid and LIP money. But the feds had previously said they had problems with the program. And according to Politifact, the program was already set to expire in 2014, and the feds agreed to extend it only until June 30, 2015.
Indeed, the leader of state Senate Republicans, who wants the Medicaid expansion, put out a statement today that seems to undercut Scott’s claims of coercion: “The federal government has no obligation to provide LIP funding, or to work within our time-frame.”
It’s hard to see how this will end. Florida writer Marc Caputo has suggested it may be resolved by a compromise in which the feds only cough up some of the LIP money Florida wants.
So here’s my suggestion for Governor Rick Scott (and state House Republicans): Take the Medicaid expansion, and say it isn’t Obamacare.
It isn’t that outlandish an idea; in fact, GOP Governor John Kasich of Ohio has done exactly this. This way, Scott would get the federal money for “poor families’ access to safety net services” he says he wants. By helping to solve the budget standoff, Republicans could get the tax cuts they want. And Scott would still be able to keep up the fight against what he’d be choosing to call “Obamacare.” Indeed, Scott may have another chance to prove his anti-Obamacare bona fides before long: If the Supreme Court guts subsidies in states on the federal exchange, Florida may be hit harder than any other state; some 1.5 million Floridians qualify for subsidies. Scott could then refuse to set up an exchange and the resistance against Obamacare would continue, even as the budget mess is resolved.
Presto — problem solved!