Florida may sue Obama administration over Medicaid expansion

Florida Gov. Rick Scott (R) has threatened to sue the federal government, claiming its refusal to continue providing funds to hospitals to treat low-income patients is a pressure tactic to get the state to expand Medicaid eligibility under the Affordable Care Act.

The battle is over what is known as the Low Income Pool, which provides about $2 billion a year to Florida hospitals to care for indigent patients, the New York Times reports. The federal government has said it would end funding the program in June.

The funding is in jeopardy primarily because Florida is transitioning its current Medicaid recipients into a managed care program, and the Low Income Pool is not designed to work in such a reimbursement environment.

"It is appalling that President Obama would cut off federal healthcare dollars to Florida in an effort to force our state further into Obamacare," Scott said in a statement, according to the New York Times. "The Supreme Court ruled that the President could not use 'gun-to-the-head' approaches in pushing for Medicaid expansion." Scott himself has flipped-flopped on the expansion issue.

In response, the White House has said simply that Scott's response is political posturing that shows how indifferent he is to his poorer constituents. "It's difficult to explain why somebody would think that their political situation and their political interest is somehow more important than the livelihood and health of 800,000 people that they were elected to lead," White House Press Secretary Josh Earnest said in a briefing last week, according to the New York Times.

Florida has about 850,000 residents who would qualify for Medicaid if the state expanded eligibility, but currently earn too little to qualify for premium subsidies on the state's health insurance exchange, according to the Miami Herald. Isabel Betancourt, a university student with an autoimmune disease who earns about $2,500 too little to qualify for a subsidy, sometimes spends her entire paycheck to pay her $192 monthly premium. 

"As crummy as this may be, I know it," Betanourt said of Florida to the Miami Herald. "I've had such a hard time here, I'm reluctant to sort of just move to New York or even California. I have no idea what is happening over there."

Florida is one of 20 states that has declined to expand Medicaid, and that policy has created a gap in uncompensated care costs for hospitals operating in those states.

Meanwhile, Texas Gov. Greg Abbott (R) announced Monday that he backs Florida's lawsuit against the Obama administration, according to the Hill. Texas has not expanded Medicaid, and it's estimated that more than 1 million Texans would be covered if the state accepted Medicaid expansion, the Hill said.

To learn more:
- read the New York Times article 
- check out the Miami Herald article
- read the article in the Hill