In Florida, Tea Party activists and Democrats have found common ground: Not knowing what to make of Republican Gov. Rick Scott, who some say has shifted to the left in recent months.
Henry Kelley, a leader of the Florida Tea Party, wrote on his blog that he has found himself in the unusual position of agreeing with Democrats in his state who are not sure what to make of Scott’s recent support of teacher pay increases, environmental protection laws and Medicaid expansion.
On the latter, he writes:
…I’m trying to determine how the Medicaid expansion under the federal Affordable Care Act is going to pay for the surgery to remove the knife planted in my back by Gov. Scott’s sudden announcement to belly up to the federal trough for “free” tax dollars.
Kelley called the blog post a “break-up note,” one that he apologized to Scott for writing publicly, adding that the governor has been “hard to get a hold of lately.”
Kelley ended it with this:
I still believe in the same things when we first met, and, well, it really is you, not me.
What you are seeing in Florida — and Ohio, and New Jersey — is the difference between politics and governing.
On the campaign trail, candidates outline their visions for leadership. They talk about their political philosophies and how they want to approach the office they are seeking. It’s grand ideas and utopian ideals.
But once they are in office, reality sets in. Most people govern largely according to the way they campaign, but few leaders — and usually the less effective ones — stick stubbornly to one political philosophy and the world be damned.
The same likely will happen here in Mississippi. Many legislative leaders have privately said they expect to see Medicaid expanded because they expect the federal government to cut the Disproportionate Share Hospital Funds for indigent care by such a level that hospitals will not be able to continue to operate without additional Medicaid funds.
It may sound good on the stump to say, “We’ll not expand Medicaid, no matter what! We’ll kill Obamacare, no matter what!” But when leaders get into office and the weight of reality starts to pull on them, political rhetoric (hopefully) gives way to governing.
Mississippi’s top three leaders — Gov. Phil Bryant, Lt. Gov. Tate Reeves and House Speaker Philip Gunn — are all three sincere in their commitment to not expand Medicaid. They believe it costs too much and will have dire effects on the financial wellbeing of our nation.
That said, all three have a responsibility to do what’s best for the state, a responsibility I suspect all three will put ahead of personal politics when the stakes are this high.
If the choice comes down to going against a professed political philosophy or seeing hospitals close or cut services, leaving rural Mississippians being left without adequate access to health care facilities, I can tell you how I think (though, admittedly, am not positive) all three will choose — the same way most lawmakers will choose as well.
Under that scenario, Medicaid will expand in Mississippi. Otherwise, it won’t. It’s that simple.
UPDATE: Another option if DSH payments are cut: The state sues the federal government. That’s all fine and good, but — barring a court order maintaining payments until the lawsuit is settled — hospitals will be hurt in the interim. Possibly irreparably so.