ACA Agonistes
Medicaid Expansion Flounders in Florida

The Medicaid expansion just lost an important convert in Florida. Around two years ago, Governor Rick Scott came out in favor of the Medicaid expansion—a seeming reversal of his opposition to Obamacare, which he personally put money into defeating. He cited the death of his mother as “[giving] him a new perspective on the issue.” Now the Washington Post reports that he has reversed himself again, saying that he opposes the expansion. At apparent issue is the so-called Low-Income Pool, a source of revenue from the federal government extended to health care providers who treat the uninsured. Scott wants that money to keep flowing, but the government says it will cut off funding from that program in June:

 Citing the LIP negotiations, Scott issued a statement Monday that he doesn’t think the federal government will live up to its funding promise, the Associated Press reported. The federal Department of Health and Human Services pushed back in a Monday statement, saying that “the law is clear” on how much support the federal government must provide for the Medicaid expansion.

The Washington Post mentions the loss might not be as big as it seems, since Scott’s commitment to the expansion even before this latest reversal may have been iffy: unlike Ohio Governor Jon Kaisch and Arizona Governor Jan Brewer, Scott did not try to use his executive powers to push the expansion through—or even actively campaign for it. Nevertheless, this is the latest in a series of setbacks for the expansion, including in Utah, Wyoming, and Montana.

For ACA supporters, these setbacks are extremely important—and detrimental to their cause. The further the Medicaid expansion spreads, the harder Obamacare is to change or repeal, because more people will be directly dependent on benefits it provides. When states limit that spread, as Florida may do, they also limit how entrenched the law becomes in the minds and the pocketbooks of their residents—ensuring that the debate over its future remains very much alive.

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