At the Plum Line Greg Sargent has been closely watching the many-splendored furor of the brouhaha in Florida over health care policy, mostly revolving around Republican arguments for and against trying to get a sanitized Medicaid expansion out of the Obama administration as opposed to finding the money to pay for a fund for charity care that is redundant under the Affordable Care Act’s scheme.
Here’s the latest from Greg:
State Senate Republicans support a “conservative” version of the expansion. The administration may withhold federal money for the Low Income Pool — which pays hospitals to treat the uninsured — that Scott and Republicans prefer, and instead wants Florida to take the expansion money, which would cover at least 800,000 Floridians. But that’s Obamacare, so Americans for Prosperity, Governor Scott and state House Republicans are dug in against it. Result: A budget impasse that’s imperiling, among other things, the tax cuts Republicans want.
The Low Income Pool angle is particularly interesting, as Jonathan Cohn points out at Huffpost:
[E]xpanding Medicaid in Florida would likely require a net investment by state taxpayers that, over the course of a decade, would work out to less than a half-billion dollars a year. That’s without accounting for any additional growth and tax revenues that the huge infusion of federal dollars might provide. That’s also without accounting for the more than $1 billion a year in that, without expanding Medicaid, Florida would probably have to scrounge up in order to help hospitals defray the cost of charity care.
In short, if the numbers were lopsided in favor of expanding Medicaid before, they are even more lopsided now. And it’s not as if anybody is arguing seriously that those grants are a superior way of financing care for the poor. If anything, the opposite is true — and it’s one reason the editorial page of the Tampa Bay Times called Scott’s position “indefensible.” Other editorial pages, civic organizations, and business groups across the state have made similar statements.
Since even Rick Scott has trouble defending the idea of spending a billion bucks a year to provide care for a relatively small group of Floridians instead of spending half that to cover 800,000, he’s suing the feds to try to force continued funding of the Low Income Pool. Even that approach is a bit risible since Scott and other Republicans claim it’s their inability to depend on future federal funding for an expanded Medicaid that justifies turning down all that federally funded care.
Meanwhile, Scott’s Republican foes on this issue are following the lead of GOPers in other states who have decided to cut deals letting them introduce conservative policy concepts into Medicaid and getting the federal government to pay for it. Even they will probably insist on calling whatever is produced by such a deal something other than “Obamacare” or “Expanded Medicaid.”
As Cohn points out, what the Florida saga shows all over again is that GOP hostility to Obamacare is increasingly about everything other than its merits:
It could be the fact that Democrats finally accomplished something big, for the first time in several decades, thereby expanding the welfare state at a time when conservatives thought they were on their way to shrinking it. Or it could be the idea that, on net, the Affordable Care Act transfers resources away from richer, whiter people to poorer, darker people. Or it could be the fact that “Obamacare” contains the word “Obama,” whose legitimacy as president at least some conservatives just can’t accept.
You kinda get the sense that if the Affordable Care Act had been named the Ronald Reagan Memorial Privatization of Government Health Insurance Act and passed with GOP votes, we might not be having these arguments today.