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February 21, 2013

Florida Governor Rick Scott Caves On ObamaCare, Will Expand Medicaid

Rick Scott rode his opposition to ObamaCare to the governorship of Florida. Yesterday he completed his journey to the dark side and embraced a massive extension of Medicaid via Obamacare.

To be sure, Scott argues that his decision is only temporary and contingent on federal taxpayers picking up the entire cost of the expansion. The way the law was written, the federal government agreed to cover the full cost for the first three years, and gradually raise the state contribution until it reaches 10 percent. Scott has proposed sun-setting the expansion to expire after three years, or earlier if the federal government backed off their commitment to fully fund it.

In practice, however, this sunset idea is incoherent. Scott is up for reelection in 2014, and no matter who is in office, it’s doubtful that after three years of allowing broader Medicaid eligibility, that the state would suddenly kick people off the program or prevent new Floridians from enrolling under eligibility standards that have prevailed for three years. Even Scott seems to acknowledge this by saying, “I want to be clear that we will not simply deny new Medicaid recipients health insurance three years from now.” Realistically, this was Scott’s one and only chance to resist the Medicaid expansion, and he folded.

Florida under Scott was among the first states to sue to overturn ObamaCare. I guess if you can't beat Chief Justice John Roberts and Obama you might as well join them.

Scott's decision has to be passed by the state legislature. But what are the odds of them saying no to "free" federal money, especially when Medicaid helps pay for nursing home costs? There are a few old people in Florida you know.

Scott's one concession seems to be the Medicaid expansion will be administered through a system of private plans he's created. One problem, that plan has been a failure to date.

The privatization expands on a five-county pilot program that has been rife with problems. Critics worry for-profit providers are scrimping on patient care and denying medical services to increase profits. Some doctors have dropped out of the pilot program, complaining of red tape and that the insurers deny the tests and medicine they prescribe. Patients have complained they struggled to get doctor's appointments.

Several health plans also dropped out of the pilot program, saying they couldn't make enough money. Patients complained they were bounced from plan to plan with lapses in care. Nearly half of the 200,000 patients enrolled in the pilot have been dropped from at least one plan, federal health officials noted at one point during negotiations.

Lawmakers say they have fixed the pilot program's shortcomings, with provisions including increased oversight and more stringent penalties, including fining providers up to $500,000 if they drop out. The measures also increase doctors' reimbursement rates and limit malpractice lawsuits for Medicaid patients in hopes of increasing doctor participation in the program.

I'm sorry but a government program that fines people for leaving it because the program cost them money doesn't sound very conservative or free market to me.

Scott just agreed to kill the state of Florida.

Medicaid serves about 3.3 million people in Florida at the moment, so another million people will be roughly a 30 percent increase. 30 percent of current $21 billion annual cost that is “consuming Florida’s budget” is $6.3 billion. When the state ends up covering 10 percent of that, it’ll add up to a cool $630 million – probably more, since these figures are unlikely to hold steady through 2020.

So a system that is a failure in a few county pilot program is now going to expand exponentially and work just as forecast? Sure.

Oh and once we do amnesty and all those newly created legal residents are eligible for full medicaid benefits, what happens to the budget?

And this is from a "conservative" governor.


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posted by DrewM. at 09:45 AM

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