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Thursday, February 21, 2013

Rick Scott's Justifications for the Medicaid Expansion are Totally Disingenuous

Rick Scott was elected governor of Florida on a backlash against the Obama Administration and the Democratically controlled Congress and their focus in 2009-10 on welfare and regulation rather than jobs and economic growth. He has spoken against Obamacare repeatedly.  Backed by the Republican-controlled legislature of Florida, Scott put Florida in the forefront of the Constitutional challenges to Obamacare.  .

So it was quite a shock yesterday afternoon when Scott announced that he would support the State of Florida agreeing to the Medicaid expansion contained in Obamacare, albeit for only three years when the Federal government pays 100% of the cost. Scott's justification of his change in position is an intellectual embarrassment.

He says "it is a common-sense, compassionate step forward", about "helping the poorest and weakest".  and reflects thinking he has done since "the death of [his] mother."

Come on.  If it's based on "compassion" and "helping the poorest and weakest", why is it limited to three years?   He is compassionate as long as someone else is paying for it? He felt like "helping the poorest and weakest" for, hmm, three years - yeah, that feels right. That's absurd.

Even more disingenuous is his explanation that "I believe in a different approach.  But a Supreme Court decision and a presidential election made the President's mandates the law of the land". First of all, that "my hands are tied" explanation belies the cloak of "compassion" he threw over his change of position.  What does he mean - he fought his hardest not to be compassionate but he lost, so now he has to be?

But more importantly, insofar as the Medicaid expansion is concerned, the Supreme Court's Obamacare  decision permits each state to do what it wants.  It didn't tie his hands at all.  The states won that part of the litigation, 7-2.  The decision may have made "the President's mandates the law of the land" in relation to individuals (actually it didn't even do that; it simply validated the tax on not having health insurance), but, in relation to  the Medicaid expansion, it struck down the Medicaid expansion as a "take it or forfeit all Medicaid assistance" mandate and said the federal government could not reduce Medicaid assistance if a state declined the expansion.  So the "law of the land" is that Florida has a choice.  Pretending it doesn't is totally disingenuous.

As far as the Presidential election goes, we may be getting closer to the truth behind Scott's decision.  Obviously, a Presidential election does not speak directly to what each state has to do on a particular policy.  Had the GOP run a more electable candidate like Chris Christie, who was not subject to the populist demonization that Romney was so obviously vulnerable to, there might have been a different result. But that didn't happen and history is written by the winners (and their allies in the media).  The decision of the GOP  to put up an electoral loser like Romney unfortunately led to an outcome that validates populist rhetoric as a winning political strategy for the time being, and Scott probably recognizes that, as a successful businessman with a nine or ten figure net worth, he is electorally vulnerable to the same tactics that took Romney down, so this decision on the Medicaid expansion is nothing more than an attempt to insulate himself from that type of attack.

This may be the right move politically because obviously there are a lot of seniors voting for the GOP in Florida, and a lot of seniors get Medicaid as well as Medicare so this may matter to his electorate more than other issues on which he may oppose the Administration.  But the justifications he gave for it are just disingenuous.

It could be that this is part of a calculated strategy with the Republicans in the state legislature who will sink it, although that seems like a losing strategy, as I don't think the electorate will give Scott any credit for his position if he doesn't deliver the result he supports. More likely, the careful calculation that has occurred is that each Republican legislator will now be able to vote in the manner that best suits his or her re-election chances, and the most at-risk legislators are being given cover to vote yes, while the ones who represent a solid Tea Party electorate will be free to vote no, and magically the bill will pass with just enough votes to win and then we will see what happens when Scott comes up for re-election in November of 2014.

This may be good politics, or it may fail totally, but it's completely politics, and neither compassion nor the Constitution have anything to do with it.