Florida Politics

Rick Scott, Charlie Crist agree on taking Medicaid expansion money, but not on how to do it

Charlie Crist
Charlie Crist Pedro Portal

As he gains momentum in the race for governor, Charlie Crist is driving a conversation on Medicaid expansion.

The Republican-turned-Democrat has become such a fervent supporter of the policy that he said he would consider using an executive order to get it done.

“A million Floridians are not getting the healthcare they need because of Rick Scott’s lack of effort,” Crist told the Herald/Times. “Florida deserves to have a governor who understands that this is affecting people’s lives.”

Republican Gov. Rick Scott — who went from opposing Medicaid expansion to supporting it, albeit without ever really lobbying for it — hasn’t talked about the issue on the campaign trail.

But Scott said he was not surprised Crist would consider using an executive order, drawing a comparison to the president.

“That is what President Obama does — refuses to work with legislators and just goes his own way and issues decrees,” he said in a statement.

Observers say the issue might be key in the final weeks of the campaign.

“This could help Crist drive Democrats to the polls,” Barry University political science professor Sean Foreman said, noting that Crist’s strategy relies on high voter turnout in left-leaning counties like Broward and Palm Beach.

Most polls consider the race a dead heat. But some have Crist pulling slightly ahead — a notable change from past weeks when the better-funded Scott had the advantage.

Medicaid expansion has been a contentious issue since it was first announced as part of the federal Affordable Care Act.

Florida Democrats and some Senate Republicans have said the state ought to accept $51billion in federal money to expand the program, which provides health insurance for the poor. Most of the state’s business associations and healthcare providers agree.

“It is in our interest to see this happen because we’ve seen countless problems with patients who show up in our facility, many of whom work, but don’t have insurance,” said Steve Mason, who heads the private, non-profit BayCare Health System in Tampa Bay.

But the conservative Florida House has blocked Medicaid expansion for the past two years. Some Republican representatives are philosophically opposed to accepting the federal funds because it would grow the national debt. Others have argued that the federal health insurance program is too broken to expand, and Florida ought to come up with its own, more sustainable plan. An estimated 800,000 to 1million Floridians remain uncovered by insurance.

Scott initially opposed expansion. When he changed his mind in 2013, it made headlines across the country. PolitiFact Florida rated the move a full flop.

In a statement to the Herald/Times this week, Scott clarified his position.

“I said that I would only agree to expand Medicaid if it did not cost Florida taxpayers,” he said. “It would be wrong to make promises to provide care that the state could ultimately not afford or sustain.”

But Scott never pushed the policy with the Legislature, or tried to persuade House leaders to change their minds. He hasn’t campaigned on it, either.

Foreman called Medicaid expansion a “sticky issue” for the incumbent.

“It doesn’t do him any good to support Medicaid expansion as a campaign issue,” the Barry University professor said. “His party is against it. The Legislature refused to move it last year.”

Despite his willingness to take the money, Scott has made it clear that he opposes the federal healthcare law. He recently called Obamacare “a bad law that just seems to be getting worse.”

Crist, meanwhile, has made Medicaid expansion a central focus of his campaign. The Democrat said he would move on the issue immediately upon taking office.

Crist said he would prefer to work with the Legislature and would consider calling a special session. He said it might be possible to win support in the House after outgoing Speaker Will Weatherford’s term ends in November.

“He was the main impediment,” Crist said. “Some of the other personalities will change as well.”

Crist said he had not discussed the issue with incoming House Speaker Steve Crisafulli, R-Merritt Island. But in a statement provided to the Herald/Times, Crisafulli called Obamacare “a disaster” and pointed out that Florida wasn’t alone in refusing “Obamacare Medicaid expansion.”

Crist has said he would consider taking executive action. He pointed to Ohio Gov. John Kasich, who signed an executive order expanding Medicaid in his state last year.

Whether such a strategy would work in Florida isn’t clear. Kasich circumvented the Legislature with the help of an obscure legislative panel known as the controlling board. Florida has no such entity.

Scott said he would not circumvent the Legislature.

“An expansion of Medicaid could not be accomplished on a whim from the executive office,” he said in the statement. “It requires legislative action.”

Crisafulli, the speaker designate, also doubted such a move would be legal.

“[Crist] is making desperate campaign promises to motivate Obama supporters to come out and vote for him,” he said.

Most of the business groups that support Medicaid expansion have held strong in their support for the pro-business Scott.

But Crist’s position on Medicaid expansion — and the potential for an executive order — will likely resonate with voters.

A recent poll from the Democratic-leaning survey firm Public Policy Polling found that 61 percent of voters favor Florida taking the federal money.

The support is even more pronounced among Hispanic voters. Two-thirds of Hispanic voters surveyed this month by Latino Decisions, a leading Latino political opinion research firm, said they would be more likely to vote for a candidate who supports Medicaid expansion.

Autar Kaw, an independent voter and mechanical engineering professor at the University of South Florida, said the issue helped him decide which candidate to choose.

“I was disappointed that Gov. Scott didn’t push for the Medicaid expansion,” said Kaw, who cast an absentee ballot for Crist. “I hope that if Charlie Crist becomes governor, he will accept it.”

Medicaid expansion has also been a factor for Juan Galán, a Republican from Coral Gables who said he was “leaning heavily toward Crist.”

“It’s important,” the retired investor said. “We need to have a way to help people who unfortunately can’t help themselves.”

But John Kubik, a 65-year-old contractor from Casselberry who votes Republican, said his top priority was electing a governor who opposes the federal healthcare law.

“I don’t think that it is good for the country,” he said, pledging his support for Scott.

Contact Kathleen McGrory at kmcgrory@MiamiHerald.com.

This article includes comments from the Public Insight Network, an online community of people who have agreed to share their opinions with the Miami Herald and WLRN. Become a source at MiamiHerald.com/insight.

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