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Florida's Rick Scott grudgingly makes the right call on Medicaid

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Florida Gov. Rick Scott (R), who has made hating "Obamacare" his raison d'etre, really did not want to accept the Medicaid expansion policy in the Affordable Care Act. When the Supreme Court made the policy optional, Scott was among the first to announce that he would ignore the offer. When the Obama administration tried to work with him on the issue, the far-right governor got caught lying about Medicaid in order to prevent its expansion.

But in the end, the Florida Republican just couldn't figure out a way to ignore the arithmetic.

A bitter critic of Obamacare, Florida Governor Rick Scott announced a surprising change of opinion on Wednesday, saying he would back an expansion of Medicaid in the state. The Tampa Bay Times called it an "amazing policy reversal." Scott had derided the program as a "job killer" and said last summer that the state would opt out of the expansion, a key part of President Obama's health-care reform. [...]

"It is not a white flag of surrender to government-run health care," Scott said. "While the federal government is committed to paying 100% of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care."

Scott is now the seventh Republican governor to accept Medicaid expansion -- as recently as a few months ago, there were zero -- but his decision arguably has the biggest impact. Indeed, given Florida's size and population, Scott has, with this one decision, cleared the way for bringing health care access to 1.3 million Americans, expanding the reach of Obamacare to new heights.

It's a three-year commitment -- Scott is apparently looking at this as a trial run, with strings attached -- but it's nevertheless a remarkable change in direction for the unpopular Republican, who's spent the last few years bragging about his unyielding opposition to President Obama's health care law and everything in it.

And whether Scott intended this or not, it also ups the ante for other states, most notably those with Republican governors.

To reiterate a point from earlier in the month, the way the Affordable Care Act is structured, Medicaid expansion is a great deal for states, and should be a no-brainer for governors who care about lowering health care costs, insuring low-income families, improving state finances, and helping state hospitals.

The only reasons Republican governors would balk is if (a) they're afraid of their party's base; (b) they plan to run for president and don't want this to be used against them in a primary; (c) they're bad at math; or (d) some combination therein.

For Scott, a Tea Party champion, the calculation led to an answer he couldn't ignore. What's more, note that in his statement, he said he can't deny the uninsured access to care "in good conscience." This, too, increases the pressure on his fellow Republican governors -- Scott is effectively saying only heartless, callous bastards would punish the poor this way.

Also, keep an eye on the larger trend of the Florida Republican trying to moderate his image in advance of his re-election bid next year. Scott is one of the nation's least-popular governors, but he seems eager to improve his standing -- by moving to the left. The governor recently reversed course on voting restrictions, he's proposed raising teacher salaries, and now he's expanding Obamacare.

Apparently, Republicans implicitly realize that the way to become more popular in 2013 is to move away from the right and closer to the mainstream -- which necessarily means embracing more progressive views.