Rick Scott: Medicaid Expansion Would Strain State Budgets

About Rick Scott:

Rick Scott is the Republican governor of Florida.

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.

[See a collection of political cartoons on healthcare.]

Some might argue that the federal government will pick up the tab, so states won't have to worry. But the truth is, they're promising to pay for only the first couple of years before they begin shifting the burden to the states. Various groups, inside and outside of government, have estimated the impact to Florida would get increasingly more substantial as time goes on—totaling into the billions over the next 10 years.

Some argue that the states have the option to return to previous Medicaid spending levels after the federal government starts backing out, but that's an unrealistic expectation. We saw that firsthand with education. When Washington cut off the roughly $1 billion in stimulus money to our education budget, our people demanded that our state legislature and I replace it. It wasn't easy, but we did it. We don't want to be forced into a position where we have to choose between Medicaid and education or other important parts of our state budget.

We just can't afford this kind of "help" from the federal government.

The safety net programs already in place in our state cover the needs of the most vulnerable. But if we don't implement a real solution to our healthcare and economic problems, there will never be enough to meet the demand.

[See a slide show of 10 things that are (and aren't) in the healthcare bill.]

We need to help people get the skills and education they need to get a job, and help the private sector succeed so it has jobs to offer. Then you'll have fewer people dependent on government programs because they'll be pulling themselves out of poverty and financial distress.

Since 2009, I've advocated free-market reforms of patient choice, competition, accountability, and personal responsibility to lower healthcare costs. That's the real problem with our system. If we can make healthcare more affordable and help people get jobs, more people will have access to the care they need, and we won't overburden the nation's taxpayers in the process.

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Tags:

government,

healthcare,

Florida,

Medicaid