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Rick Scott's health care adviser predicts odds of Medicaid expansion 'very low'


“My name is Alan Levine. I'm a conservative," the head of Health Management Associates introduced himself Thursday to a group of healthcare journalists in Doral. Who better than the Republican party healthcare guru to forecast the state's chances of expanding Medicaid? 

"Very low," was Levine's take on those chances, and, on further prodding, "less than 30 percent."

Timing is one of the biggest reasons for his low vote of likelihood. With upcoming elections and the fumbles of the Affordable Care Act's launch, Republicans think they have the upper political hand to stay their course of resistance to Medicaid expansion, even if it means forfeiting billions of federal funds and hurts the poor.

Another reason is the distrust with which state conservatives hold the Obama administration, although the reasons are laced with political hyperbole.  "We were never invited to the table," Levine said of Democrats' healthcare initiatives since the late Sen. Ted Kennedy. 

Levine, who led Gov. Rick Scott's health care transition team three years ago, also cited Florida conservatives' strong sense of self-determination when it comes to healthcare, creating programs that have served in some cases as pilots for national reforms. He believes Medicaid expansion Florida-style would expand health insurance coverage rather than the traditional federal program, and thinks the Obama adminsitration will move closer to giving Florida a clean sheet of paper to design such a program after the election.   

Levine insisted that "I think the right, politically correct and moral decision is to take the federal money for expansion for the poor," adding that even Florida House speaker Will Weatherford has the poor's interests at heart. 

But political interests will overshadow moral ones for the foreseeable future, he said. 

"People have boxed themselves in politically is what I see, and they won't touch it (Medicaid expansion) because it gives the President a victory." 

He also implied that the repeal-and-replace approach might be a strategy that would appeal to Florida conservatives as a DIY form of expanding healthcare coverage for state residents. 

"I think someone should create a bill repealing it (Obamacare) and giving states the freedom to create their own programs. How do you get a conservative to say no to that?" Levine said.