Litigation isn’t leadership

Don’t be fooled by Gov. Rick Scott’s phony lawsuit against the federal government over Medicaid expansion. It’s a politically inspired grandstand play that utterly fails to protect the interests of the people of Florida.

Ostensibly, the lawsuit is about the end of a federal program called LIP (Low Income Pool) that partially reimburses hospitals that care for indigent and low-income uninsured patients. In effect, it has been superseded by Obamacare, which offers the states federal funding to expand Medicaid.

The problem is that the state’s Republican leaders want the $2.2 billion that LIP provides, but they reject Medicaid expansion — for purely political reasons. Hence Mr. Scott’s lawsuit, which defies logic: It demands that the federal government offer Florida one pot of money even while the state rejects another.

Memo to Mr. Scott: The Supreme Court said that states don’t have to accept Medicaid expansion as part of the Affordable Care Act, but it never said rejection was a good idea. It ruled that states can opt out of the program — and the money that comes with it — leaving them to face the consequences.

In budgetary terms, accepting federal funding to expand Medicaid would be the smart decision. In human terms, it makes even more sense: As reporter Dan Chang explains in an in-depth report that begins today in the Herald, an estimated 850,000 uninsured Floridians would be newly eligible for coverage under a Florida Senate plan that accepts federal funds to establish a state-run private insurance exchange for low-income residents.

The stumbling block is that Mr. Scott and like-minded Republicans in the House say they don’t trust the feds to keep their promise to pay for covering more Floridians. They cite withdrawal of the LIP money as both a form of coercion and as proof that the government can’t be trusted to keep its word.

This is a fundamentally dishonest argument.

In the first place, LIP is a discretionary program, a contract with the state that has expired. The Affordable Care Act, in contrast, provides money guaranteed by law. Second, state officials weren’t blindsided. They’ve known for years that LIP money would disappear. It was always tied to Medicaid expansion, for obvious reasons.

Other states are eagerly taking the money. Most recently, Indiana, a red state, became the 28th state — and the 10th with a Republican governor — to receive approval for an expansion plan. Why can’t Florida do the same?

The absence of healthcare coverage is most acute in Miami-Dade County, as today’s stories in the Herald explain in painful detail. Yet some Dade legislators — like Rep. Michael Bileca, a former member of the Jackson Health System board of trustees, and Erik Fresen, now in his last term — are not on board with Medicaid expansion. What a shame.

Meanwhile, the bad choices made by state leaders have wreaked havoc on the budget. It faces a $1.3-billion shortfall with the loss of LIP funding. Yet even though this was known to everyone, Mr. Scott irresponsibly presented a budget that ignored this crucial reality.

The Senate plan offers a way out of this budget mess by accepting Medicaid money, which would make the federal government more amenable to negotiate a new LIP contract to cover costs not met by expansion, but the House has refused to go along.

This is where a strong governor would step in and bring both sides together to craft a compromise. Instead, Gov. Scott has chosen litigation over leadership. His disappointing performance won’t resolve the budget crisis, and it will do nothing to help the 850,000 Floridians who would benefit by Medicaid expansion.

This story was originally published April 18, 2015 at 3:00 PM with the headline "Litigation isn’t leadership."