Gov. Rick Scott federal health care estimate: Scott under fire for Medicaid math

TALLAHASSEE, Fla. -- Gov. Rick Scott is again facing criticism that he is overstating the potential cost to Florida taxpayers of the federal health care overhaul.

Scott met Monday with Health and Human Services Secretary Kathleen Sebelius to express his concerns about the overhaul, which includes an expansion of the state's safety-net health care program.

The Republican governor told Sebelius that state taxpayers will have to pay near $26 billion over the next 10 years to implement the overhaul. That figure - drawn up last month by the state's main health care agency - is three times higher than one drawn up by state economists back in August.

Internal emails show that the state's top economist and a legislative budget analyst back in December challenged the assumptions the Scott administration used to reach its figure.

The administration assumed that Congress would change the federal law and reduce the amount of money that the state would receive to expand Medicaid.

The existence of the emails was first reported by Health News Florida. The news triggered a sharp response from Democrats, who say Scott is pushing up the cost to justify his opposition to the Medicaid expansion.

"Not only did Gov. Scott manufacture flawed cost estimates, but it appears he had been advised that the numbers were flawed and used them anyway," said U.S. Rep. Kathy Castor, D-Tampa.

Scott was a constant and vocal critic of the health care overhaul, but he toned down his rhetoric after President Obama won re-election. Still the Scott administration is defending the revised figures, saying that past experience has shown that previous federal estimates for entitlement programs have been wrong.

Scott spokeswoman Melissa Sellers said administration officials "look forward to reviewing" other cost estimates.

"There are three things the governor has stressed that remain unchanging in this important discussion about cost estimates," Sellers said in a statement. "First, growing government is never free. Second, the number of people in Medicaid would nearly double with the new law (from approximately 3.3 million today to over 6 million). And third, once government grows, it is almost never undone."

Michelle Dahnke, a spokeswoman for the Agency for Health Care Administration, which oversees the state's Medicaid program, said the federal fiscal climate and federal government's track record shows "it is important for the state to consider the potential ramifications of expanding Medicaid as it relates to federal and state fiscal liability."

This marks the second time, however, that Scott has come under fire for overstating the cost of the overall. Last summer he was forced to backtrack after citing incorrect estimates on national television.

Medicaid is a $21 billion safety net program for the poor in Florida and currently the federal government picks up about 58 percent of the cost.

Obama's health care law called for states in 2014 to expand eligibility of Medicaid to those making up to 133 percent of the poverty level, or $29,326 for a family of four in Florida. The changes would also require adding people who are below the poverty level but not eligible for Medicaid such as childless adults.

The U.S. Supreme Court ruled this summer, however, that expansion of Medicaid is not mandatory and that states can opt out if they choose.

Most of the Medicaid expansion and other costs are being paid by the federal government. But the state has been trying to gauge the full financial impact to state taxpayers of both expanding Medicaid as well as paying higher reimbursement rates to health care providers.

Back in the summer, economists came in with much lower figures, saying it was hard to quantify some of the costs or even figure out how many people would enroll in Medicaid due to changes.

Economists plan to meet again soon to draw up revised estimates. By law state economists must assume current policies when drawing up estimates but the Scott administration, however, is pushing for the adoption of the higher figures.

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