GOP governors make peace with Obamacare

"It is not a white flag of surrender,” Florida Gov. Rick Scott said.

This was technically true: Scott did not wave a banner of any color when he announced Wednesday that he wants Florida to expand Medicaid, a key piece of Obamacare.

But make no mistake: Scott, a Tea Party Republican and outspoken critic of the law, was laying down arms in defeat. The former hospital executive won his gubernatorial race in 2010 by campaigning against Obamacare, and as governor he fought the law in court.  Even when the Supreme Court ruled against his position last year, he vowed defiance.

“We’re not going to implement Obamacare in Florida,” he said then. “We’re not going to expand Medicaid.”

The about-face by Scott, the seventh Republican governor to accept Obama’s expansion of government-funded health care for the poor, is a crucial validation of the president’s signature initiative. In his announcement, Scott made a moral case for the Medicaid expansion as compelling as the law’s proponents ever made.

“This country is the greatest in the world, and it’s the greatest largely because of how we value the weakest among us,” said Scott, in a blazer and open-collar oxford, said in his announcement. “It shouldn’t depend on your Zip code or your tax bracket. No mother or father should despair over whether they have access to high-quality health care for their sick child.” With federal funds covering the cost, “I cannot in good conscience deny Floridians that needed access to health care.”

Conscience is trumping politics elsewhere, too, even as the Tea Party maintains its grip on Republicans in Washington. Thirteen states, mostly in the South, have so far opted out of the Medicaid expansion, according to the Advisory Board Co.  Twenty-three and the District have opted in, accepting federal funds (100 percent for three years and at least 90 percent after that) to extend Medicaid to those with incomes up to about $31,000 for a family of four. “States are deciding this deal is simply too good to pass up,” Health and Human Services Secretary Kathleen Sebelius told reporters Thursday.

In Ohio, Republican Gov. John Kasich urged lawmakers this week to “examine your conscience” before opposing his plan to embrace the Medicaid expansion. Invoking his own moral sense, Kasich said, “I can’t look at the disabled, I can’t look at the poor, I can’t look at the mentally ill, I can’t look at the addicted and think we ought to ignore them. For those that live in the shadows of life, those who are the least among us, I will not accept the fact that the most vulnerable in our state should be ignored. We can help them.”

Michigan Gov. Rick Snyder declared this month that the Medicaid expansion “makes sense for the physical and fiscal health of Michigan.” And in Arizona, Republican Gov. Jan Brewer, a hardened Obama foe, justified her decision to embrace the Medicaid expansion with language similar to that used by the law’s proponents.

“With this move, we will secure a federal revenue stream to cover the costs of the uninsured who already show up in our doctors’ offices and emergency rooms,” Brewer said in her State of the State address. “Health-care premiums are raised year after year to account for expenses incurred by our hospitals as they provide care to the uninsured.”