Florida Race Could Turn on Medicaid Expansion

Published Online: August 27, 2014
Mary K. Caffrey
The race will feature a Republican turned Democrat against a one-time supporter of Medicaid expansion who now isn’t so sure. But this much is certain: in Florida’s race for governor, health care will take center stage, as former Gov. Charlie Crist tries to unseat incumbent Gov. Rick Scott.

Crist, who was Florida’s Republican governor from 2007 to 2011, ran for the U.S. Senate as an independent and in 2012 endorsed President Obama’s re-election bid. After switching parties again, last night he captured the Democratic nomination to take on Scott. Considered one of the Republican Party’s more conservative members, Scott nonetheless surprised many with his plea two years ago to accept expansion funds to add 1 million Floridians to the healthcare rolls.

Since that time, however, Scott has backed off, telling a Florida newspaper that he “wouldn’t stand in the way,” if the Legislature wanted to accept federal funds to expand Medicaid. The Legislature rejected expansion, and many observers saw Scott as backing off his cry for help.

Unlike some Democrats running for US House and Senate seats this year, Crist frequently brings up the Affordable Care Act on the stump, and vows to do what Scott has not. Crist promises to go directly to the Florida Legislature and plea “to put aside party affiliations and do what's right for our fellow Floridians ... we can get it done and we owe it to them."

Crist is also repeating Kentucky Gov. Steve Beshear’s sales pitch and promoting Medicaid expansion as a tool for economic growth. His web site says Medicaid expansion and the creation of a Florida insurance exchange will create 71,000 jobs and “reduce the fees that business owners will be required to pay for the Affordable Care Act.”

Florida, long a battleground in presidential elections, was a healthcare battleground this year, too. The state was a top target of Enroll America, the organization grafted from the remnants of the Obama re-election organization, which used get-out-the-vote techniques to find uninsured Americans and sign them up on the exchanges.

A story appearing in The New York Times this spring centered on enrollment efforts in Florida’s counties just north of Miami, and revealed just how challenging the task was weeks before the deadline for open enrollment. As reported in The American Journal of Accountable Care, in the days after the story appeared, Vice President Joe Biden and then-US Health and Human Services Secretary Kathleen Sebelius began to scale back their projections on how many Americans would enroll. Thus, White House officials were all the more celebratory when final numbers revealed that 8 million Americans – more than original projections – had signed up.

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