Saturday, April 18, 2015

The Medicaid Expansion Paradox

I'm sure I don't need to fill readers of this blog in on the latest Rick Scott debacle involving his proposed lawsuit against the federal government over funding for hospital services for the poor. The drama is getting so thick, with Scott accusing the feds of "bullying" him and acting like mobsters, that in terms of Scott's performance, the only question is whether the comic value of Scott's performance will exceed the tragic consequences of his refusal to do the right thing. 

What I find remarkable, however, has been the long-standing reason that has been given by Scott (as well as the Florida House) for refusing the Medicaid expansion. I'll quote one of the leading nausea-producing sources on this subject, Americans for Prosperity:

"Medicaid will put an enormous financial burden on our state in the future. Expected costs have been all over the board ranging from $3 billion to more than $20 billion over the next ten years, but what is known is that Medicaid spending is expected to more than double by 2020 and Florida will be relying on the federal government to pay these costs, despite the inability of the federal government to pay its current bills. Don’t put this risk on the backs of Florida’s families."

Now for a moment, let's consider the structure of this appeal and peel back the logic. This is how it reads.

Right now, hundreds of thousands of poor Floridians are not receiving the medical care they need, because we have not accepted the Medicaid expansion.

The reason given for not accepting the Medicaid expansion is that the feds may not pay their bills for it, and it could end up "on the backs of Florida families." (We'll bypass the question of why poor people aren't also parts of "families" that have expenses on their own backs.)

But it seems obvious that if somehow, the feds stop paying the bills, all the Florida GOP will do is say, "We won't pay those bills either, or make [well off] Floridians pay for them." In other words, all they'd do is say that we'll just have to return to what the status quo was before the Medicaid expansion.

Do you see how it goes? Scott and his Tea Party allies are rejecting the Medicaid expansion on the basis that they are afraid it will end up so that things are exactly as they are right now for Florida's poor and medically needy.

We already know that you have to be particularly out of touch with reality to support Rick Scott. It helps, though, to have an example of why that's the case.

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