Although Florida Governor Rick Scott launched his political career with opposition to the federal health-care reform law, Scott recently announced that he would expand the state’s Medicaid program to cover about 1 million more poor people. According to Reuters, however, the plan suffered a setback when the proposal failed to make it out of a key state legislative committee hearing. The House Select Committee rejected the expansion, and a Senate counterpart committee postponed consideration of the issue.

On February 20, Scott announced his support for a three-year expansion of Medicaid, provided the federal government picks up the full cost for the first three years as promised. This decision came as a shock, since Florida was one of the states that sued to try to block the law. Last year, the Supreme Court ruled that though the law was constitutional, states could choose not to expand their Medicaid programs, and Mr. Scott had said that Florida would not expand.

Scott explained that there were no perfect options on the Medicaid decision. Floridians would either have to pay to fund the program in other states while denying health care to their own citizens, or they could use federal funding to help some of the poorest in the state with the Medicaid program and explore other health care reforms.

The Medicaid expansion in Florida relies heavily on a waiver needed to privatize Medicaid, and the state has been running a pilot project to see if the program could improve patient care. Shortly before Scott made his announcement of expansion support, Federal health officials said they expect to approve Florida’s request to privatize Medicaid statewide, as long as the state resolves several outstanding issues. After nearly two years of negotiations between the state and the Centers for Medicare and Medicaid services, health officials would require Florida to hire an independent entity to monitor the process and to have a plan to measure the quality of patient care.

But there’s conflict between the governor and the state legislature over the Medicaid expansion. Republican legislative leads have been openly hostile toward the plan and argue that the federal government might not keep its end of the bargain, leaving Florida with increased Medicaid patients and reduced funding. Furthermore, many critics are concerned with the costs. Although the federal government promises that it will cover all the costs for the first three years, only 90 percent of funds will be covered after that time period.

As the Senate pushed the issue aside, more controversy will rise over whether the Medicaid expansion is beneficial for Florida and its citizens. Many conservatives are “disappointed” with Scott’s expansion support, but Mr. Scott said his mother’s recent death and her lifetime struggle to raise five children with “very little money” played a role in his decision: “While the federal government is committed to paying 100 percent of the cost, I cannot in good conscience deny Floridians that needed access to health care.”