Certainly one of the biggest political losers coming out of the Supreme Court decision upholding of Obamacare is Florida Governor Rick Scott. As Jeremy Wallace of the Sarasota Herald-Tribune noted, no political figure in the nation has tied himself more to the defeat of President Barack Obama’s health care reform program than Scott.
Scott didn’t just lose his political gamble that the reforms would be declared unconstitutional. Now he has a major public policy problem: Implementing a law after rejecting millions of dollars in federal aid aimed at helping Florida and other states get started.
But what happens if Scott ‘stands in the doorway’ to block, or at least drag his feet on, the implementation of Obamacare in Florida? Does it then become the key policy issue of the 2014 gubernatorial campaign?
More specifically, did the Supreme Court just hand Charlie Crist or Alex Sink yet another reason to run against Scott?
All of these questions assume that Scott will, in fact, block or slow down the implementation of Obamacare. It’s not a stretch to envision Scott taking the same tack as Louisiana Governor Bobby Jindal who, on Fox News last night, promised not to implement Obamacare.
“We’re not moving forward with the exchanges, we’re not going to be implementing ObamaCare here in the state of Louisiana,” said Jindal. “Instead, we’re going to do everything we can to defeat President Obama, get rid of ObamaCare.”
Then, as if he weren’t clear enough, Jindal doubled down on his promise, “Absolutely, we’re not implementing the exchanges. We’re not implementing ObamaCare.”
Would it really surprise observers of Scott’s administration if Jindal’s words were to echo from Tallahassee?
The Supreme Court ruling still leaves Republicans with an opportunity to blow a major hole in the law: individual states can choose to opt out of the Medicaid expansion in 2014 without losing federal funding, explains Suzy Khimm of the Washington Post. That could leave some low-income Americans caught in a “no man’s land.”
Democrats, most notably Nancy Pelosi, do not believe this will happen. “I don’t think governors will turn that down. People have the need, the urgency is there,” the House Democratic Leader told reporters on a press call Thursday afternoon.
Pelosi has obviously never met Rick Scott.
Still, it will be extremely difficult for conservative states to opt out once their residents see how other states are benefitting from the Medicaid expansion. “Once this bill is rolling and people experience benefits of it, it’s very hard for a state to say [no],” Pelosi said. States will also receive full federal funding for the first three years of the expansion before they have to take up more the expense, which Pelosi described as a major incentive to get them to participate.
Medicaid already absorbs $21.4 billion of Florida’s $69.9 billion state budget. State taxpayers pick up $9.7 billion of the program, with the remainder covered by the federal government.
State officials said Florida taxpayers will have to pay $121.2 million more next year, mostly to cover the enrollment of those already eligible for coverage but who have stayed out of the program for various reasons. The Affordable Care Act’s mandate is likely to bring these Floridians into Medicaid.
But cost of annual coverage is expected to reach an additional $473 million by 2016, reports John Kennedy of the Palm Beach Post.
But health care advocates have argued the Affordable Care Act is worth the extra cost. Florida has 4 million have no health coverage, among the largest populations in the nation without coverage.
Even with the federal government absorbing all of the initial expansion costs, the implementation of Obamacare will, by 2020 cost an extra $1 billion in Florida.
That extra cost may be reason enough for Scott to drag his feet as much as possible. But if he does, he risks the Democratic nominees hammering him for denying millions of Floridians better health care coverage.