- Associated Press - Wednesday, February 20, 2013

Florida Gov. Rick Scott on Wednesday became the latest Republican to green-light the expansion of Medicaid under President Obama’s health care law, a move that follows in the footsteps of other state leaders who opposed the president’s reforms and then accepted federal dollars to insure more low-income residents.

Mr. Scott is the seventh Republican governor to support an expansion of Medicaid, after notable “Obamacare” critics such as Arizona Gov. Jan Brewer and Ohio Gov. John Kasich extended the entitlement program to those earning up to 133 percent of the federal poverty level.

Republican governors in Michigan, Nevada, New Mexico and North Dakota also have opted to expand Medicaid enrollment in accordance with Mr. Obama’s signature first-term legislation.

In a late-afternoon news conference, Mr. Scott said that despite his opposition to Mr. Obama’s initiative, the results of the presidential election in November and the Supreme Court’s decision in June “made the president’s health care mandate the law of the land.”

The Obama administration has pledged to pay for 100 percent of the expansion for three years, starting in 2014, before scaling back the federal contribution to 90 percent by 2020.

“While the federal government is committed to paying 100 percent of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care,” Mr. Scott said.

Conservative-minded governors and lawmakers are leery of the expansion’s costs and the federal government’s ability to live up to its promises, so they are building in safeguards to scale back their obligations if the expansion does not go as planned.

Mr. Scott warned that his expansion would sunset after three years and need to be re-authorized. He also said the federal government would have to hold up its end of the bargain under the Patient Protection and Affordable Care Act.

The administration has noted that states can start or stop the expansion whenever they want and that it would give states flexibility in how payments are structured.

Mr. Scott agreed to the expansion hours after he secured a waiver from the Obama administration to set up a managed-care program that he expects will cut costs and make health care delivery more efficient.

He also emphasized his business experience over his political credentials, cautioning that his expansion of Medicaid “is not a white flag of surrender to government-run health care.” Ultimately, he said, job creation is the best path to universal health coverage.

“Get a job at a company that provides health care,” he said.

Florida is among the 26 states that have declined to set up and run state-based health care exchanges, virtual insurance markets that allow those without employer-based coverage to buy health care plans with the help of tax credits. The federal government will run exchanges in those states.

Mr. Scott reaffirmed that decision Wednesday, citing the “many unknowns” surrounding plans to set up the insurance markets.


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