Florida Gov. Rick Scott (AP/J Pat Carter)
On Wednesday, Florida Gov. Rick Scott, one of the most outspoken critics of President Obama’s Affordable Care Act — and the Medicaid expansion it carries with it — announced that Florida will accept the federal windfall that the program will bring. This is a major about-face for Scott: When the Supreme Court ruled the Act constitutional, but said states could opt out of the Medicaid expansion, he was one of the first governors to announce that his state would not participate.
As we noted last July, the states that whose leaders have fought most aggressively against Obamacare tend to be the ones with the most to gain from the Medicaid expansion. The health care law extends Medicaid coverage to people making up to 133 percent of the poverty line — for an individual, that’s $14,857 per year. By comparison, many red states cap Medicaid coverage at a fraction of that. Texas, for example, restricts Medicaid coverage to people making less than 26 percent of the poverty line: $2,905 per year.
I f states accept the Medicaid expansion, they won’t have to pay any additional money until 2017, after which the federal government would continue to pay 90 percent of the added Medicaid costs. For states with especially stingy Medicaid restrictions, the potential budget benefits are enormous. Texas, for example, has calculated that by refusing the Medicaid expansion, it stands to lose $100 billion in federal funds over the next 10 years. Even so, Texas Gov. Rick Perry is standing firm in his rejection.
However, Perry is in an ever-dwindling group. Seven Republican governors have now signed on for the Medicaid expansion, and nearly a third of the states that have agreed to it so far are right-leaning. Gov. Scott is not the first Republican to get on board, but he may be one of the most influential: He’s the first of the big Obamacare critics to break ranks.
Some states may continue to hold out against the Affordable Care Act’s Medicaid expansion, but given the enormous quantities of federal money on the table, chances are, eventually most governors will follow Scott’s lead. As for those who don’t, in a few years, they may find their successors aren’t quite so ideologically rigid.