Florida's negotiations with the Obama administration over Medicaid—and by extension, Obamacare's Medicaid expansion—got even more complicated Monday, when Republican Gov. Rick Scott walked back his previous support for expanding the low-income health-insurance program.
The Associated Press first reported Scott's change of heart Monday. In a statement, the governor effectively blamed the Obama administration's posturing in the ongoing negotiations over a Medicaid funding stream, the Low-Income Pool, which helps pay for uncompensated care.
"Given that the federal government said they would not fund the federal LIP program to the level it is funded today, it would be hard to understand how the state could take on even more federal programs that CMS could scale back or walk away from," Scott said.
The federal Centers for Medicare and Medicaid Services has said the LIP program, which expires in June, won't be renewed as is; Scott has tacitly accused CMS of using that $1 billion in federal money to pressure the state to expand Medicaid under the health care reform law.
His new position hardens the gap between the state and the feds, while also upending the internal Florida debate. In the state legislature's ongoing budget debate, the Florida Senate supports a modified form of Medicaid expansion, while the House opposes it altogether.
The two sides have been negotiating for months, but things took a bizarre turn last week when Scott's administration accused CMS of pulling the plug on the talks. The lead federal negotiator went on leave—for Passover, according to a friend—but Florida Health Secretary Elizabeth Dudek called the stoppage "sudden and disappointing" while warning that it could mean "an abrupt end" to the LIP program.
Now, a few days later, Scott's statement is likely to strain the situation even further.
After campaigning hard against Obamacare to get elected governor in 2010, Scott said in February 2013 that he would support Medicaid expansion if it cleared the state legislature, though he never lobbied forcefully for its passage.
His statement Monday didn't necessarily preclude his signing a Medicaid expansion bill if it did pass the legislature—which most consider highly unlikely—but it sent a clear signal in the midst of the negotiations with CMS that it isn't a priority for him.
CMS didn't immediately respond to a request for comment.