Full Flop
On expanding Medicaid as part of the health care law

Rick Scott on Tuesday, February 25th, 2014 in public statements

Rick Scott opposed Medicaid expansion before he supported it

States across the country are still debating whether to expand Medicaid to serve the poor as part of the federal health care law.

Florida Gov. Rick Scott is on record supporting an expansion, but he did not always hold that view. Scott’s critics continue to argue he isn’t pushing for the expansion hard enough.

It’s sure to be an issue in the governor’s race, so we wanted to look at the evolution of Scott’s position on the issue on our Flip-O-Meter, which evaluates whether a politician changed their stance -- we leave it up to voters to make judgments about any such changes.

(Scott is expected face former Gov. Charlie Crist, now a Democrat -- we have evaluated several  Crist stances on our Flip-O-Meter.)

Medicaid and the health care law

Medicaid is a joint state-federal, government-run health care program for the very poor. The federal government agreed to fund 100 percent of the cost for states to expand Medicaid for three budget years. The Medicaid expansion would allow states to offer health insurance to all of the poor. Before the law, you had to be poor as well as either disabled, elderly, pregnant or a child to qualify.

The law says the federal government will cover 95 percent of the costs in 2017, gradually declining to 90 percent of the costs in 2020 and beyond.

Even before he ran for governor Scott was a persistent critic of President Barack Obama"s federal health care push. In 2009, Scott spent $5 million of his own money to form Conservatives for Patients' Rights and oppose the law.

But on June 28, 2012, the U.S. Supreme Court upheld Obamacare.  At the time, about 3.8 million people -- or about 21 percent -- of the state’s population was uninsured. The Supreme Court’s ruling said that states could skip the Medicaid expansion without facing financial penalties.

In response to the ruling, Scott said on Fox News that Florida would not expand Medicaid, adding that it "just doesn’t make any sense" and that it was too costly.

Then a change of position

On Feb. 20, 2013, Scott summoned the media to the governor’s mansion where he announced that he still opposed setting up a state exchange but now supported a three-year Medicaid expansion. Scott said that a three year expansion would allow the state to then judge if it was working before deciding whether to re-authorize it.

"On the question of Medicaid expansion, there are no perfect options. To be clear, our options are either having Floridians pay to fund this program in other states while denying health care to our citizens, or using federal funding to help some of the poorest in our state with the Medicaid program as we explore other health care reforms...," he said. "While the federal government is committed to paying 100 percent of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care."

At the time, Scott said that his mother’s recent death gave him a new perspective. "As I wrestled with this decision, I thought about my Mom’s struggles raising five kids with very little money," he said.

The tea party crowd pounced on Scott’s flip-flop. "This is just another example of Republicans lying to Floridians," said Everett Wilkinson, a tea party activist, calling Scott "the Benedict Arnold to the patriot and tea party movement in Florida."

Though Scott supported the Medicaid expansion, he also made it clear it wasn’t one of his legislative priorities. The Legislature ended up rejecting the expansion, which included $51 billion in federal dollars over 10 years.

In an interview with reporters in Washington on Feb. 24, Scott was asked about his opinion on Medicaid expansion and said he still supports it.  

Our ruling

Scott fought the health care law before he became governor, and after the law passed, he continued to fight it. After the Supreme Court upheld the law, Scott said definitively that he opposed the Medicaid expansion.

But several months later, in February 2013, Scott announced that he supported Medicaid expansion. He qualified that position by saying he wanted to try it for three years, so Florida could then judge how it was working. But he didn’t push the Legislature to approve it, and legislators ultimately rejected the expansion.

In 2013, Scott completely reversed his stance on Medicaid expansion. So we rate this a Full Flop.