Fla. Gov. Scott Reverses Medicaid Decision

Florida Governor Rick Scott announced late Wednesday that he will expand Medicaid to an estimated 900,000 residents. The move is a surprise because the governor has previously been a vocal critic of President Obama's health care overhaul.

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There are few politicians in America who fought harder against the Affordable Care Act than Florida Governor Rick Scott. Under the health care law, nearly a million additional Floridians are eligible for Medicaid if the state agrees to the expanded coverage. After the law was passed, Scott said he believed that would cost the state too much money. But as NPR's Greg Allen reports from Miami, the Republican governor now says he's changed his mind.

GREG ALLEN, BYLINE: It's a remarkable reversal for Rick Scott, who got into politics to fight President Obama's effort to overhaul healthcare. The former CEO of the nation's largest for-profit hospital chain, Scott founded a group that lobbied against passage of the Affordable Care Act.

After he became governor in 2010, Scott said he opposed a key provision of the law - one that expands Medicaid eligibility. Last night in Tallahassee, he held a news conference to say he still believes government-run healthcare will lead to less patient choice, worse care and higher costs.

(SOUNDBITE OF PRESS CONFERENCE)

GOVERNOR RICK SCOTT: But regardless what I believe, or anyone else, a Supreme Court decision and the election last November made the President's health care mandates the law of the land.

ALLEN: Under last summer's Supreme Court decision, it's up to states to decide whether to expand Medicaid eligibility to more low income families and individuals. The Obama administration has worked to make it an attractive option for states, promising to pay 100 percent of the new Medicaid coverage for the first three years and 90 percent of the costs after that. Despite that, Scott continued to hold out until last night.

(SOUNDBITE OF PRESS CONFERENCE)

SCOTT: We will support a three-year expansion of our Medicaid program under the new healthcare law, as long as the federal government meets their commitment to pay 100 percent of the cost during that time.

ALLEN: After those three years, Scott says, Florida will decide whether to continue with an expanded Medicaid program or withdraw. It's a similar approach to that advocated by another conservative Republican governor, Ohio's John Kasich. Like Kasich, Florida Governor Scott now has to get state legislators onboard.

STATE SENATOR DON GAETZ: I think that his change of heart and his additional perspectives will carry weight.

ALLEN: The head of Florida's Senate, Republican Don Gaetz, says it will be several weeks before the legislature finishes its work on healthcare and decides whether to expand Medicaid. He says the cost of the program in future years is just one issue. There's also the question of whether it makes sense for so many Floridians to be dependent on the government for their healthcare.

GAETZ: If we expand Medicaid as the Governor has recommended one out of every four Floridians would be on Medicaid. That's a rather substantial dependence of our citizenry on the tax payers for healthcare.

ALLEN: Comments from Florida House Speaker Will Weatherford are even less encouraging for the governor. He said he's skeptical, quote, "This inflexible law will improve the quality of healthcare in our state and ensure our long-term financial stability."

For some conservatives, especially Tea Party supporters, Scott's decision to expand Medicaid is more than just a bad choice, it's practically a betrayal. Erick Erickson of Red State.com calls it a sad day for conservatives. And here's Slade O'Brien, head of Florida's chapter of Americans for Prosperity, a group founded by conservative businessman David Koch.

SLADE O'BRIEN: Flabbergasting and disappointing, to say the least.

ALLEN: Rick Scott was elected governor in Florida with strong Tea Party support, in part because of his opposition to Obamacare. O'Brien says he expects many of Scott's one-time supporters will now be working against him in the legislature.

O'BRIEN: I would assume that the grassroots in the state of Florida will become very engaged in this process.

ALLEN: As he prepares for his 2014 re-election campaign, Scott has begun to moderate some of his staunch conservative positions, calling for more spending on the environment, for example, and raises for teachers and state employees. Now he's gone a step further, endorsing a healthcare law he once fought to overturn. Greg Allen, NPR News, Miami.

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