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Rick Scott and Scott Randolph pen competing essays on Medicaid expansion

Gov. Rick Scott is pushing back against critics of his choice to reject the federal Medicaid expansion, emphasizing in this opinion-editorial that it will be a costly policy move for states and the better strategy is -- you guessed it -- to create jobs so more people can afford their own insurance.

His piece appeared on U.S. News and World Report's "Debate Club" blog on Tuesday. Among experts arguing for the expansion is Democratic Rep. Scott Randolph, D-Orlando, who says "uninsured care costs Floridians at least $5 billion per year—not including what hospitals just write off."

It follows a report from the Tampa Bay Times this weekend that quoted several health experts who warned the costs of not expanding Medicaid could outweigh the price of implementation. How? Florida's 3.8 million uninsured residents will continue to receive care they don't pay for in emergency rooms, which will continue getting passed down to people who buy insurance in the form of increased premiums.

Scott writes: 

History has repeatedly shown that the costs of many government healthcare programs far exceed early projections. Why does anyone expect the expansion of Medicaid would be any different? We don't need the federal government telling us what to do when it comes to meeting the needs of the citizens of our states. And we don't need Washington putting states on the hook for future budget obligations.

Medicaid expansion is bad for states because it would put a tremendous strain on state budgets and increase dependency on government programs. We don't need to expand a big-government program to provide for everyone's needs. What we need is to shrink the cost of healthcare and expand opportunities for people to get a job so more people can afford it. In Florida, Medicaid is the fastest-growing part of our state budget—hands down. It is increasing at more than 3.5 times the rate of our general revenue. And that's before we even begin talking about an expansion.

It doesn't take a mathematician to figure out that such a trajectory doesn't bode well for our budget. And unlike the federal government, which isn't required to balance its budget, expanding Medicaid could only be paid for by increasing taxes or cutting from other parts of the state budget. The Medicaid expansion would put other vital government functions like education, public safety, and infrastructure at risk. Frankly, that isn't something I'm willing to do.

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