Gov. Rick Scott, federal government, reach deal to expand Medicaid

Florida Gov. Rick Scott The federal government has granted the Medicaid waiver Florida Gov. Rick Scott said was his condition for expanding the program, and Scott is following through. The federal government conditionally agreed to allow the state to expand on a pilot project that privatizes Medicaid, and Scott has decided to take the expansion funds.

The privatization plan expands on a five-county pilot program that has been rife with problems. Critics worry for-profit providers are scrimping on patient care and denying medical services to increase profits. Some doctors have dropped out of the pilot program, complaining of red tape and that the insurers deny the tests and medicine they prescribe. Patients have complained they struggled to get doctor's appointments. [...]

Lawmakers say they have fixed the pilot program's shortcomings, with provisions including increased oversight and more stringent penalties, including fining providers up to $500,000 if they drop out. The measures also increase doctors' reimbursement rates and limits malpractice lawsuits for Medicaid patients in hopes of increasing doctor participation in the program.

The privatization pilot project has moved 200,000 patients into managed care programs. But according to some health care advocates, the approved plan differs significantly from the original pilot project, saying it has "stronger accountability, oversight, and transparency requirements." The deal is conditional on both sides, with the legislature needing to sign off on it on the state's end. What the federal government's conditions are hasn't been released yet. If it goes through, as many as one million uninsured Floridians could receive coverage.

Scott was the first governor to sue to strike down Obamacare, but the new political reality of denying health care to so many of his constituents seems to have helped change his mind on the issue.

'While the federal government is committed to paying 100 percent of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care,' he says according to a prepared text of his remarks.

'We will support a three-year expansion of our Medicaid program under the new healthcare law, as long as the federal government meets their commitment to pay 100 percent of the cost during this time.'

What happens after that three years during which the feds pick up 100 percent cost isn't yet known. But Scott will have been either reelected or booted out, so he's probably not thinking that far ahead.