A lot of people got upset with Governor Scott for reversing his position and embracing Medicaid expansion under Obamacare.
But for a politician, this was a no brainer. The Feds are going to pick up the entiire tab for the first three years and 90% for the next three. More than a million Floridians will be covered who weren't covered before.
That's a lot of votes.
But Scott may not have realized that a doctor shortage is going to make treating that extra million people a challenge:
Currently, the state has 44,804 doctors, but about 5,600 of them are expected to retire in the next five years. And even though Florida has opened three new medical schools in the past dozen years, the state isn't producing as many doctors as it needs. Scott's budget this year has $80 million to fund programs to train 700 new residents a year, in hopes they'll remain in the state.
Of all patients, people covered by Medicaid may have the hardest time finding a doctor; only 59 percent of the state's physicians are taking new Medicaid patients, according to a Kaiser Health News study.
Committees in both the House and Senate have been meeting for the past two months to discuss implementation of the Affordable Care Act. On March 4, they expect to see two major studies by the Office of Economic and Demographic Research, one that looks at the overall economic impact of the health-care overhaul and another that simply examines Medicaid expansion.
Scott, however, has already made clear how he feels about that.
On Wednesday, he unexpectedly announced that he had reversed his earlier, adamant opposition and now wants a three-year expansion that would cover single adults and families earning up to 138 percent of the poverty line; the costs would be fully covered by the federal government. If the expansion is re-approved after three years, the federal government is committed to paying no less than 90 percent of the cost.
House and Senate leaders will begin their budget deliberations in the coming weeks, which will include the decision over new residency slots, along with the debate over whether to expand Medicaid. Many lawmakers have expressed opposition.
Sen. Joe Negron, R-Stuart, who chairs the Senate committee studying the AFA, said lawmakers have heard concerns about a potential physician shortage, but he said he did not believe that would be a "determining factor" in the committee's decision over whether to expand Medicaid.
One reason, he said, is the responsibility for coverage may soon be falling to private health insurance companies or physician groups.
This is the old "cross your fingers and hope" scenario - one that rarely works. Scott may have done his constituents a huge disservice and whatever votes he may think he was going to get for adding citizens to insurance rolls, he may end up losing because he will be blamed if the system becomes overloaded and begins to crack.