In a just-issued report issued, Moody’s Investor Service warns that public hospitals and those providing loads of charity care could have revenue – and therefore bond problems – in states where legislatures don’t opt to increase Medicaid enrollment under Obamacare.
Moody’s reasoning is simple: less money means more risk for lenders. More risk potentially can mean worse bond ratings. And worse bond ratings can theoretically mean higher payments on debt.
That’s not the primary reason Gov. Rick Scott wants to expand Medicaid, which could give the state a $6.7 billion shot in the arm over three years. But it helps reinforce his argument and the argument of other conservatives, including former Florida House Speaker Tom Feeney, who now heads the Associated Industries of Florida.
Feeney called on the Legislature to look at the report. They probably will, and then go back to refusing to accept the Medicaid money, particularly in the conservative House, where “Obama” is a four-letter word.
Earlier today, we asked Scott about the report and Medicaid. Here’s what he said.
Does this report reinforce what you were saying about the need to expand Medicaid for at least three years?
Scott: “I opposed the president’s bill because I believe there’s a better way of doing it. I think the free market would have given more people access to healthcare. But it’s the law of the land. It was upheld by the Supreme Court. Governor Romney lost his race.”
(Scott then mentioned that the state received approval to turn over Medicaid management to HMOs)
Scott: “One thing people haven’t talked about is that the waivers are really going to help us a lot. It’s going to give us the opportunity to control the costs of Medicaid but also give us the opportunity to use a managed-care program that should improve access to quality care.”
“Based on that, and the fact that taxes aren’t going away -- we’re paying all those taxes, and the federal government is going to pay 100 percent [of the cost for the new Medicaid program for three years] – then I can’t in good conscience deny people access to healthcare . I know that we need to work to improve the system. That’s what we need to do in the next three years.”
Q: Is there a job-creation argument to be made here, would accepting the Medicaid money be good for the economy?
Scott: “I think what people need to look at is: We’re already paying the taxes. The federal government is basically reimbursing us dollars we’re already paying. I know there’s also been conversation about the DSH dollars, but there are overall dollars that have been cut out of the Medicare program. Others have run the numbers. They’ve shown the dollars the federal government cut out of Medicare is more than that [the extra Medicaid money].”
Q: Have you lost this fight to expand Medicaid?
Scott: “I’m still confident that the House and Senate understand that we’ve got to take care of taxpayers in our state. But we’ve also got to take care of people who don’t have health insurance. So I’m optimistic they’re still going to do the right thing.”