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Rick Scott's alternate Medicaid reality

Several Republican governors have found themselves in an awkward spot.

Several Republican governors have found themselves in an awkward spot. On the one hand, federal Medicaid expansion is an exceptional deal for their states, and they'd be foolish to turn it down. On the other, they're supposed to hate everything about the Affordable Care Act for ideological reasons, and resist its provisions regardless of merit.

As a result, we see governors like Florida's Rick Scott (R) looking for excuses to turn down the Medicaid expansion that common sense suggests he should accept.

In this clip, Scott talked on Monday to reporters in DC, and said he's inclined to oppose the administration's Medicaid policy on cost grounds: the expansion, he said would cost about $63 billion over the next decade overall, and Florida would be expected to cover $25.8 billion of that total.

The problem is, the governor knows what he's saying isn't true. As the Orlando Sentinel reported, "Gov. Rick Scott has taken to the airwaves in recent weeks to declare that the federal health-care law's Medicaid expansion would come at a much higher cost to Florida than previous estimates. Turns out he may have been fudging the numbers."

Health News Florida reported this week that state budget analysts told the governor in a series of emails weeks ago that his cost estimates are wrong. Scott doesn't seem to care.

The flawed report, "Estimates Related to the Affordable Care Act," was sent to members of the Legislative Budget Commission on Dec. 17. Three days later, two of the recipients pointed out the faulty assumptions and sent it back to AHCA for a do-over. They said it would violate Florida law to proceed with the estimate.But Michael Anway, Scott's new coordinator for health policy and budget, sent an e-mail Friday to the others saying he will submit the original estimates as an "alternative forecast" when the revised AHCA report comes before the next budget estimating conference.

As far as the governor's office is concerned, federal law includes unambiguous Medicaid funding levels, but since federal spending levels may change, there's no harm in making arbitrary assumptions about the future and relying on those inflated/exaggerated figures as accurate.

In other words, the governor's office was told in writing that Scott's numbers don't match with reality, so the governor's office created an alternative reality in which Scott's numbers might be true and deserve to be repeated publicly.

Told that they couldn't include deliberately wrong information in official state forecasts, Scott and his aides decided to publish the bogus information anyway as an "alternative forecast."

For the record, independent groups such as the Kaiser Family Foundation have concluded that Medicaid expansion would probably cost Florida about $8.9 billion over the next decade, not $25.8 billion. This number is based on existing law and facts. [Update: The Health News Florida report originally misstated the KFF's findings, and this paragraph now reflects the accurate data.]

But Rick Scott doesn't want to be bothered with facts; he has an ideological axe to grind.

Would now be a good time to point out that Scott's claim to fame, before getting elected, was his involvement in suspected health care fraud?