By Ashley Lopez
Florida Center for Investigative Reporting
Whether or not the state will accept billions of federal dollars to extend health insurance to some of its poorest residents just became less likely.
Ever since the U.S. Supreme Court ruled states would be able to opt-out of Medicaid expansion under the Affordable Care Act, this essential piece of public health policy has been left up to state legislatures across the country. Florida’s Legislature has chosen not to take part in the expansion. Gov. Rick Scott said he supported it, but the GOP-led legislature has been staunchly opposed.
After this week’s Republican dominance of the mid-term elections, it looks like expanding Medicaid to about a million uninsured Floridians will be even less likely.
Tuesday’s re-election of Republican governors in closely contested races in Florida, Georgia, Wisconsin, Maine and Kansas dims the chances of Medicaid expansion in those states.
Advocates hoping for Democratic victories in those states were disappointed by the outcomes, but Alaska, which also has a Republican incumbent, remains in play as an independent challenger holds a narrow lead going into a count of absentee ballots.
“No one would say it was a good night for the prospects of Medicaid expansion,” said Joan Alker, executive director of the Center for Children and Families at Georgetown University.
Still, Alker said the playing field for Medicaid expansion didn’t shift dramatically. “The debate continues to be within the Republican party — with more pragmatic Republicans saying yes and ideologues driving the opposition. So what happens next is a good test case to see how Republicans will resolve these internal tensions.”
…In Florida, Republican Gov. Rick Scott has supported Medicaid expansion, but has done little to persuade state lawmakers to extend the program to 850,000 residents.
If Democratic challenger Charlie Crist had won, he would have faced strong opposition in the Republican-dominated state House, said Sean Foreman, associate professor of political science at Barry University in Miami Shores. “Scott’s victory means Medicaid expansion is dead the next four years,” he said.
Crist said on the campaign trail that he would use his executive powers, if elected, to get Medicaid expansion through without state lawmakers.
Scott once publicly supported Medicaid expansion, but did little to convince state lawmakers to embrace it. Since then, Scott has not committed to trying to get it done.
Tuesday night, however, The Tampa Bay Times reported that Crist asked Scott to consider pushing for it.
In his victory speech to supporters Tuesday night, Gov. Rick Scott described his defeated rival Charlie Crist as “very gracious.”
On Wednesday, Crist added some details to that brief phone call, including a push to expand the Medicaid program in Florida.
Crist said he told Scott: “I just want to wish you well even though we had our differences” — which, considering the tone of both candidates’ TV ads, is probably the greatest understatement of the campaign. The conversation turned to Scott’s view that the campaign was over and it was time to move the state forward, and Crist said he told Scott: “Medicaid expansion might be an area where you can bring Florida back together.” As Crist recalled it, Scott told him: “‘I’ll look at that.'”
While GOP leaders in the Florida House have been staunchly opposed to any form of Medicaid expansion, leaders in the Florida Senate have been open to accepting federal funds to offer private insurance to those who qualify.