The Miami Herald | EDITORIAL

Editorial: Medicaid expansion the right call

There is governance, and there is politicking. One is grounded in practicality; the other floats — and sinks — on ideology. Commendably, Gov. Rick Scott has learned the difference after two years in office.

The governor’s decision to back the expansion of Medicaid by 1 million Floridians who would qualify (after having been elected to office on an anti-Obamacare platform) is a practical call that protects the state’s taxpayers.

By putting a limit of three years to Florida’s expansion effort, the governor also seeks some wiggle room to see if the expansion delivers the cost savings the feds have promised. Mr. Scott’s decision comes after the federal government approved Florida’s move to privatize the Medicaid program by having the poor who qualify select coverage from among state-approved HMOs.

Mr. Scott could not in good conscience pass up the federal government covering the entire costs of the Medicaid expansion the next three years now that the Supreme Court has ruled that the Affordable Care Act (aka Obamacare) is constitutional.

“There are no perfect options,” Mr. Scott said last week when he made his about-face. “Our options are either having Floridians pay to fund this program in other states while denying healthcare to our citizens or using federal funding to help some of the poorest in our state with the Medicaid program as we explore other healthcare reforms.”

Indeed, as it is, Floridians send more tax dollars to the federal government than they get back in various key areas, like the gas tax used to fund transportation projects. In a state where the Great Recession hit particularly hard and the number of unemployed (and uninsured) remains stubbornly high, the Medicaid expansion could deliver long-term healthcare cost savings and better health to the newly insured. The only way to find out is to test it — and that goes for the controversial privatization element of the expansion.

Gov. Scott’s decision has attracted some strange political bedfellows into his detractors’ camp. Predictably, the Democratic Party pooh-poohs the governor’s decision as a purely political one meant only to help his poor polling numbers as he heads into a re-election campaign in 2015. The GOP’s tea party groups, meanwhile, are calling the governor a disparaging RINO — Republican In Name Only — because he is now ready to participate in Obamacare and has given up their hard-right fight.

Mr. Scott, a former healthcare executive, has moved to the center recently on various issues. This year, for instance, he’s proposing a $2,500 pay raise for teachers after having cut education funding his first year in office. No doubt there are solid political reasons to back more education funding now, a popular issue with voters. But there also are practical economic reasons to invest in education, and the business community has made that clear to the governor, too.

The Republican-led Legislature will have to make the final call on Medicaid expansion and teachers’ salaries and all things budget-related. Expect some members to let ideology trump practicality. That would be irresponsible.

Now that Florida’s economy is slowly turning around and is poised to generate thousands of new jobs in trade, medicine, bio-tech, tourism and the like, the state needs sensible leaders who can do the math, add up the numbers, subtract the liabilities and reach the answer regardless of party ideology.

The governor deserves credit for making the responsible call.

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