The growing GOP divide over ObamaCare

In a striking reversal, Florida Gov. Rick Scott, whose state launched a lawsuit against ObamaCare, said this week that his administration would expand Medicaid as the federal law calls for, after all.

Scott explained that Florida had managed to sweeten the deal by getting the Health and Human Services Department to grant a waiver allowing the Sunshine State to shift Medicaid recipients to managed care plans after a few years. The more immediate impact, however, will be to extend Medicaid coverage to a million uninsured Floridians.

Scott tried to head off a backlash from conservatives by saying that he "cannot in good conscience deny the uninsured access to care," especially since the federal government, not Florida taxpayers, will foot the entire bill for the expansion for the first three years. Then, after a trial run, Scott says the state will be able to reassess before committing any of its own money to keep the program going. It's a strategic move, says Allysia Finley at The Wall Street Journal. Scott's poll numbers have been mired in the 30s, and he "may figure the Medicaid expansion is his ticket to re-election," because it will allow him to run as "a common-sense, compassionate conservative."

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The reversal also means Scott has changed teams in the GOP's internal feud over ObamaCare, according to David Nather and Jason Millman at Politico. The fight is between "two camps of Republican governors sure to duke it out in the 2016 presidential primary — ideologues versus pragmatists." On Team Ideologue "are big-name Southern governors — like Bobby Jindal, Nikki Haley, Bob McDonnell, and Rick Perry — who have all said 'hell no' to major pieces of the law, even turning down free federal cash to expand Medicaid in their states." Scott is a "big convert" for the "more pragmatic governors who are rising Republican stars in the rest of the country — like Chris Christie, John Kasich and Susana Martinez — who've embraced pieces of the law or left the door open to doing so if there seems to be a political upside in their state."

Well, Scott's low approval ratings were almost certainly the primary factor in his switcheroo, Michael Cannon, director of health policy studies at the Cato Institute and a member of Scott's 2010 transition team, tells National Review. Still, he's dreaming if he thinks there won't be a price to pay. Now, he's "vulnerable to a potential primary challenge," and he might lose some of his old supporters.

This divide really isn't so shocking when you take a closer look, according to some analysts. It's true that, "in the span of a month, some of ObamaCare's most ardent opponents have come to embrace" the Medicaid expansion, says Sarah Kliff at The Washington Post. And, yes, that's "one of the law's most crucial programs." It's also true that Scott is the seventh GOP governor to sign up. But the math is pretty easy to understand.

What it boils down to, says Steve Benen at MSNBC, is that the "Medicaid expansion is a great deal for states, and should be a no-brainer for governors" who want to lower health care costs, get low-income families insured, and improve their state finances.