Gov. Rick Scott is sending the right signals in the days following the Nov. 6 election. A day after agreeing to a review of voting policies that led to nine-hour long lines in some precincts, the governor who began his political career opposing President Barack Obama’s signature universal health care law is preparing the state’s health care bureaucracy to begin implementing it. Unfortunately, his reticence put the state far behind in the process and will delay residents access to coverage.
After declining to start setting up private insurance exchanges once the U.S. Supreme Court ruled on June 28, 2012 that the law was constitutional, Scott’s administration had until Friday to notify the U.S. Department of Health and Human Services of its intent to set up the exchanges or have the federal government do so. States have only until Dec. 14 to submit an actual blueprint.
On Thursday, Scott’s spokesman said, “Gov. Scott wants to work with HHS to identify solutions that are good for Florida families by reducing cost and improving quality and access in health care.” It’s not clear that Scott’s change of heart extends to accepting billions of dollars in federal Medicaid grants he refused earlier this year. Scott had said accepting the additional funding would lead to higher Medicaid costs for the state, but a study released by the Health Policy Institute at Georgetown University argued it would actually save Florida money on the health insurance program for nearly 1 million uninsured poor residents.
Two other studies released this week, including one done by the University of Florida on behalf of the Florida Hospital Association, reached similar conclusions. The UF study concluded secondary effects of the health care law and the expansion of Medicaid would include an additional 54,000 jobs in the industry in Florida alone. Hospitals are generally in favor of the state expanding Medicaid because they stand to lose reimbursement funds for treating uninsured patients, but still will be required to treat them.
Now that the political calculations that went into Scott’s earlier stances are moot, we encourage him and his staff to review those studies, crunch their own numbers and base policies on real numbers and real people who will gain access to health care coverage, millions for the first time.
Under the Affordable Care Act, states are reimbursed for 100 percent of the new costs for expanding Medicaid during the first three years and 90 percent or higher through 2020. We share Scott’s concern about rising Medicaid costs. In 2009, Medicaid represented 19 percent of the state’s budget. By 2011, it had risen to 26 percent, although that figure is slightly inflated by the reduction on the state’s budget during the recession and post-housing bubble financial crisis.
In Florida, 27.6 percent of Medicaid spending — almost $5 billion in 2010, according to an analysis from the respected Kaiser Family Foundation — is for long-term care of the elderly poor in nursing homes, assisted living facilities and in-home care. There are serious budgetary debates to be had about controlling health care costs for all of Florida’s residents, but we’re fairly certain we don’t want to be known as the state that balanced its budget by throwing little old ladies out of nursing homes.
With Scott facing reelection in 2014, we suspect Floridians will be seeing a warmer and fuzzier version of the governor in the months to come.