Scott retools his rhetoric on health care law

Gov. Rick Scott entered the political fray on a hard-charging crusade against President Barack Obama's health care reforms.

He pledged to repeal the law -- deriding it as the "the biggest job killer ever in the history of this country” -- and to support a proposed constitutional amendment that aimed to undermine its implementation in Florida.

Politifact Florida is tracking 57 of Scott's campaign pledges, including his anti-Obamacare promise, on the Scott-O-Meter. When the Florida Legislature succeeded in 2011 in placing such a constitutional amendment on the ballot, PolitiFact Florida awarded Scott a Promise Kept.

Much has changed since then. Scott, out of political and practical necessity, is changing, too.

He's taking a cue from Florida voters, who re-elected Obama and rejected the state's anti-"Obamacare" amendment.

Almost 52 percent of Florida voters killed Amendment 1, which would have prohibited any laws that require people to have health insurance or businesses to offer it. (The amendment would likely not have had an effect on the state's compliance with the health care law anyway, as federal law supersedes state law.)

Months earlier, the U.S. Supreme Court upheld the law and its individual mandate, which imposes fines on most people for not buying health insurance, Florida led the multi-state lawsuit challenging the constitutionality of the law and its individual mandate.

Scott remained defiant and berated the court's decision in national TV interviews. He said Florida should not go forward with the optional components of law: expanding Medicaid to cover more uninsured poor people and creating a state health insurance exchange.

Like many Republicans, Scott placed his last hope for repeal of the law with the election of Mitt Romney. Obama's win signaled the health care law is likely here to stay.

Scott's reaction to the development was uncharacteristic, to say the least. He told reporters he's ready to negotiate with the federal government on implementation of the law.

"Gov. Romney did not win the election," Scott said. "So it is not an option to repeal Obamacare. My goal now is to focus on what's good for our citizens."

States have three options to create a health insurance exchange, which is essentially an online marketplace for people to comparison-shop plans. They can set it up themselves, they can set it up with the federal government, or they can do nothing and allow the federal government to do it.

It's still not exactly clear which option Scott wants to pursue. What is clear is his no-way approach to the health care law is dissipating.

Scott requested a meeting with Health and Human Services Secretary Kathleen Sebelius in a letter sent Nov. 16, the original deadline for states to tell the federal government whether they want to create exchanges. Sebelius extended the deadline for states to report how they want to proceed to Dec. 14.

"The citizens of our state are hopeful that you will accept our offer to partner with you to work together on solutions that will address the ever-increasing cost of health care and the need for better access by all Florida families to quality health care,” Scott wrote.

"While I continue to be concerned with the unanswered questions regarding the implementation of PPACA, I know that we share the same goals when it comes to lowering the costs of health care and addressing the need for better access to quality health care for not only Floridians, but for all Americans.”

Scott doesn't let on which way he prefers, choosing instead to reiterate his desire for a Medicaid waiver and using "families” five times in the first paragraph.

"He's basically saying, 'now that you've won the election, how about doing everything the way I want to do it?' " said Timothy Jost, a law professor who studies health policy at William and Mary Law School.

Still, his conciliatory reaction is a contrast from that of other Republican governors like Texas Gov. Rick Perry, who told the feds he would not set up a state-run health insurance exchange because he did not want to put "hard-working Texans on the financial hook for an unknown amount of money to operate a system under rules that have not even been written.”

The Florida director of the conservative advocacy group Americans for Prosperity applauded Perry and nine Republican governors for saying they would not create an exchange, but he criticized Scott, House Speaker Will Weatherford and Senate President Don Gaetz for sending "the exact wrong signal.”

"Florida should not agree to be the de-facto administrator of the federal government's rules, regulations and mandates,” executive director Slade O"Brien said in a statement.

There's a long way to go on the creation of an exchange. The state has wasted two years and millions of federal dollars that it could have already devoted toward setting up an online market, said Laura Goodhue, executive director of Florida CHAIN, a health advocacy nonprofit group.

She said she hopes Scott will include consumer advocates in discussions about the exchange and that he reconsiders his decision not to expand Medicaid.

"He's a businessman,” she said. "I'd like to think that he's just being reasonable.”

There's no doubt Scott supported efforts to prevent Florida from enforcing the law, be it via lawsuit, constitutional amendment or outright refusal. But voters turned down the amendment that aimed to do that, and Scott's hands are tied with Obama in office.

Here, we are evaluating Scott's promise to fight for repeal of the health care law.

Scott says he is willing to negotiate on the health care law. The results remain to be seen.

We are pushing this promise to Compromise.