Governor Rick Scott says Florida can't afford Medicaid expansion, but staff says no decision yet

Asked if Florida would expand its Medicaid coverage under the federal health care law, Gov. Rick Scott said Friday the state cannot afford it.

"I don't know how we're ever going to be able to afford it," Scott said on WOKV-Radio in Jacksonville.

Scott dismissed prospects of providing the coverage for more low-income, elderly and disabled Floridians, even as health care advocates rallied at the state Capitol in support of the U.S. Supreme Court's ruling a day earlier.

Officials in the governor's office emphasized later Friday that Scott hasn't made a decision on whether Florida should expand Medicaid.

"He has policy staff and legal staff working on this," Scott spokesman Lane Wright said. "He wants to make sure we fully understand what the decision means for Florida before moving forward."

The federal law required the expansion of Medicaid beginning in 2014, and provided that the federal government would pay for 100 percent of the expansion until 2016, when the states would start paying a share that would gradually increase to a maximum of 10 percent of the new costs in 2020.

But that expansion became clouded Thursday when the Supreme Court threw out a provision that would have allowed the federal government to penalize states that don't expand by withholding all their Medicaid dollars, not just the extra money they would get for the expansion.

The Supreme Court opinion essentially gives states the option of keeping their current Medicaid programs without losing current federal Medicaid dollars, or expanding, which would net them more federal money but also cost them more state tax dollars.

Scott said Medicaid already absorbs a huge chunk of the state's $69.9 billion budget, although the federal government pays for more than half of the state's current Medicaid expenses as well.

"Medicaid is the biggest issue we have," Scott said. "It's growing at three and a half times our general revenue. We can't afford it."

But representatives of Florida CHAIN, a statewide health advocacy organization; the League of Women Voters; and seniors and children's health providers met at the Capitol Friday to call for Scott and other Republican leaders to embrace the Affordable Care Act and end two years of resistance to President Obama's centerpiece legislative victory.

"This state needs to start moving forward," said Brad Ashwell, representing CHAIN, who helped organize Friday's rally.

Florida has 4 million people without health insurance, one of the largest populations without coverage in the nation, but without fear of significant penalties, Florida Republican leaders have said the state is likely to stand pat on Medicaid.

Under the expansion, categories that currently determine Medicaid eligibility would be eliminated and anyone whose household income is 133 percent of the federal poverty level or less would be eligible – meaning annual income of about $15,000 for individuals or just under $30,000 for a family of four.

State officials have said the proposed expansion could increase Florida's Medicaid rolls from 3 million this year to 5 million people by 2020. Officials say that expansion would increase Florida's share by $1 billion.

Meanwhile, a Florida adviser to Mitt Romney said Friday that Floridians have pumped close to $400,000 of the $4.6 million pouring into the presumptive Republican presidential nominee's campaign since the court's ruling Thursday.

Sixty percent of the 4,000 Florida contributors were first-time donors to the campaign, said Alberto Martinez, with the Romney campaign.

The News Service of Florida contributed to this story.

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