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When Florida’s Republican governor Rick Scott accepted Medicaid expansion, many observed that it was mostly because he’s extremely unpopular and facing election next year, and he was more afraid of losing the general election to former governor Charlie Crist than a primary to a Tea Partier.

That’s certainly part of the story.

Like Republican governor Rick Snyder of Michigan, who also is calling on his state legislature to accept the expansion, Scott has spent much of his term appeasing the far-right Republicans who put him in office in what some call a Tea Party binge. So in an effort to seem somewhat centrist in states President Obama won, both agreed to allow his signature accomplishment to extend health insurance to any legal resident earning up to 138 percent of the poverty level.

But in all the celebration of Scott agreeing to cover about a million uninsured Floridians, the three-year waiver he negotiated with the federal government didn’t get its much-deserved attention. And Scott seems to have planned it that way.

“A few months ago, my mother passed away, and I lost one of the only constants in my life,” he said. “Losing someone so close to you puts everything in new perspective . . . especially the big decisions.”

He also suggested that he was considering the “poorest and weakest,” which is not exactly a point he was making when he was lying about the cost of Medicaid expansion.

With talk like that, Scott was instantly called “Benedict Arnold” by some Tea Partiers. But they likely missed the real story by underestimating Scott’s willingness to bilk the federal government.

“Scott’s hospital company, Columbia/HCA, pleaded guilty to criminal charges and paid a total of $1.7 billion in fines related to Medicare fraud,” according to PolitiFact. “Even though Scott had resigned by the time the case settled, prosecutors said the widespread fraud occurred while he was at the helm.”

This history would make many reluctant to let Scott anywhere near taxpayer money. However, industry lobbyists are lusting over the sweet deal Scott made before deciding to accept the expansion: Florida will be allowed to privatize its Medicaid program that currently covers about three million residents.

The Department of Health and Human Services (HHS) agreed to this even though Scott and Florida’s GOP had already been experimenting with Medicaid privatization to disastrous results. Nearly half of the 200,000 residents signed up to the program had been dropped by the private provider because they didn’t offer a big enough profit margin.

“…[I]nsurance companies got into the program thinking they’d make a lot of money, only to discover that they actually had to care for people who were expensively sick,” explains Mother Jones’ Stephanie Mencimer, who notes there’s no evidence that the program saved the government a dime.

The goal of privatization of public resources, of course, isn’t cost savings. It’s creating corporate profits, aka corporate welfare.

And what Scott negotiated was the motherlode of corporate welfare — up to $66 billion in federal funds in the next decade.

HHS seemed desperate to get one of the largest states in the union to take the expansion, especially as reimbursement rates for Florida’s millions of Medicare beneficiaries are being cut as part of Obamacare. Medicaid expansion was designed to make up for that lost income, while cutting the cost of the uninsured receiving care they can’t afford through emergency rooms.

Scott seized on this desperation to negotiate a deal that will wet, if not saturate, the beaks of his insurance industry pals.

HHS stated that the waiver is “conditional” on improvements to the private plans with consumer protections that do not exist for the current program. And despite Scott’s record, the government was willing to take a risk to get more than a million Floridians insured.

Scott now has the chance to prove that privatization is the way forward in health care, an argument that was the entire premise of Paul Ryan’s original plan to turn Medicare into a waiver program. Or he’ll prove that the Rick Scott who ran Columbia/HCA is the same Rick Scott who’s running Florida. And he may no longer be the CEO of the state by the time we find out.

Photography by User: MrX

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