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Florida’s Scott meets Burwell after suing her over PPACA

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(Bloomberg) — Florida Gov. Rick Scott is once again suing President Barack Obama and Sylvia Mathews Burwell, Obama’s Health and Human Services secretary, over the Patient Protection and Affordable Care Act (PPACA).

That didn’t stop the Republican from coming to Washington today with his palm out, trying to salvage more than $1 billion in hospital funding that’s at the center of his lawsuit.

See also: Is Medicaid expansion PPACA blood money?

“This program shouldn’t be going away,” Scott told reporters Wednesday after meeting with Burwell at her agency’s headquarters. “The federal government shouldn’t be trying to force us to expand Obamacare.”

Scott filed a lawsuit against Obama and Burwell last week, accusing the government of withholding money intended to cover some of the costs of treating indigent patients in an attempt to force Florida into expanding its Medicaid program for the poor. Twenty-nine states have adopted the PPACA Medicaid expansion program, according to the nonprofit Kaiser Family Foundation of Menlo Park, Calif. Scott’s Florida is among the holdouts.

Scott’s lawsuit is the latest legal action by a Republican governor against the Obama administration, which has increasingly tried to use executive action to bypass Congress on issues including healthcare, immigration and carbon dioxide emissions. There are now more governors suing the Obama administration than there are that are not.

Low-income pool

The Florida suit centers on hospital funding called the Low-Income Pool, which helps the state’s poorest residents. It is scheduled to expire in June, and the loss of the funds has blown a hole in the state’s budget.

“We don’t have a resolution,” Scott said after his meeting with Burwell.

See also: Price of Florida PPACA efforts adjusted downward

Burwell urged Scott to expand Medicaid and told him that “coverage rather than uncompensated care pools is the best way to secure affordable access to health care for low-income individuals,” a spokesman for her department, Benjamin Wakana, said in a statement.

Florida Democrats who back a Medicaid expansion said Scott’s trip to Washington was a waste of time.

“Gov. Scott has failed to address the matter in a fiscally responsible way and is caught in his own ideological trap that now is causing harm to Florida,” U.S. Rep. Kathy Castor said in a statement. “He should stop going everywhere and looking to everyone else to fix Florida’s problems. He should stay in Tallahassee and work with the Senate to put Florida’s tax dollars to work for Floridians.”

No budget

Florida’s Republican-controlled legislature ended its annual session last week without passing a budget because of the disagreement over the hospital funds and whether to expand Medicaid for more than 800,000 residents. Scott, whose position on the Medicaid expansion has wavered, said he told Burwell that the state needed to know soon whether the hospital funding will continue.

The U.S. Department of Health and Human Services (HHS) has declined to comment on Scott’s lawsuit. The department’s leaders contend money from Florida’s Low-Income Pool shouldn’t pay for expenses that would be covered under a Medicaid expansion. The Republican governors of Texas and Kansas, where similar funding arrangements for indigent care are also slated to end, have said they would join Florida’s lawsuit.

State decision

“The decision to expand Medicaid, or not, is a state decision,” Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services (CMS), an arm of Burwell’s department, said in an e-mail. “We will work with Florida and each state that has an uncompensated care pool regardless of its Medicaid expansion status, to support access to health care for low-income residents that works for individuals, hospitals and taxpayers, taking into account the state’s specific circumstances.”

See also: Tennessee shows how Republicans are learning to love PPACA

Scott, a former health care executive who won a second term in November, opposed Medicaid expansion before reversing his position in 2013. Since his re-election he has reverted to opposition, saying the federal government isn’t trustworthy.

Florida must pass a budget by June 30 under the state Constitution. Without the low-income pool money, Scott said Florida lawmakers are considering a “base budget” to provide only enough money for essential services and to keep the government open.

PPACA, passed in 2010, seeks to extend health insurance to millions of people in part by expanding coverage under Medicaid, a joint state and federal health care program serving the poorest Americans. The U.S. Supreme Court ruled in 2012 that Obama couldn’t force states to expand eligibility for their Medicaid programs under the law, a decision Republicans have embraced.

See also: PPACA tax raises state Medicaid bills

Despite Republican opposition, about 16.4 million people have gained insurance coverage under PPACA, according to a March analysis of independent data by Burwell’s department.