POL­ICY:

Two newly elected gov­er­nors on op­pos­ing sides of re­form de­bate

Modern Healthcare - - Contents - Joe Carl­son

Vot­ers last week made gov­er­nors of two long­time and con­tro­ver­sial health­care fig­ures, one of whom is strongly in fa­vor of re­form­ing the de­liv­ery sys­tem, and one who takes credit for killing a key fea­ture of the fed­eral re­form laws be­fore the fi­nal vote in Congress.

In Ore­gon, vot­ers re­turned for­mer emer­gency room physi­cian and past two-term gover­nor John Kitzhaber to a third term in the state’s top elected of­fice. Kitzhaber, a Demo­crat, is the first Ore­gon gover­nor to serve non­con­sec­u­tive terms, and is known for found­ing the pro-re­form Archimedes Move­ment in 2006. As a state sen­a­tor in the 1990s, he was chief author of a plan to pri­or­i­tize what med­i­cal treat­ments Ore­gon’s Med­i­caid pro­gram could af­ford.

In Florida, for­mer Columbia/HCA Health­care Corp. CEO Rick Scott won his first elected of­fice last week, be­com­ing gover­nor of one of the most pop­u­lous and po­lit­i­cally sig­nif­i­cant states. Scott, a Repub­li­can, in 2009 chaired and bankrolled Con­ser­va­tives for Pa­tients’ Rights, which claims to have de­feated pro­pos­als to es­tab­lish a na­tional pub­lic in­surance op­tion. Ques­tion­able Medi­care billing prac­tices at Columbia/HCA un­der Scott in the mid-1990s re­sulted in the hos­pi­tal chain pay­ing some $1.7 bil­lion in fines.

Nei­ther fu­ture gover­nor scored a ma­jor­ity of the vote. Kitzhaber won by nearly 17,000 votes, with nearly 41,000 of the 1.4 mil­lion votes in the race go­ing to third-party can­di­dates. Scott won by about 61,000 votes, with nearly 182,000 of the 5.3 mil­lion votes in the race go­ing to third-party can­di­dates, ac­cord­ing to un­of­fi­cial re­turns.

Both gov­er­nors will pre­side over the planned ex­pan­sions in Med­i­caid cov­er­age out­lined in the health­care re­form law, but the pic­ture is par­tic­u­larly in­ter­est­ing in Florida, where Scott will have to make a quick de­ci­sion on fund­ing that could af­fect nearly ev­ery com­mu­nity hos­pi­tal in the state.

Namely, that is whether the state should ask for an ex­ten­sion of its cur­rent Med­i­caid waiver, which in­jects at least $500 mil­lion in fed­eral sub­si­dies into the state’s cof­fers for its pub­lic in­surance pro­gram for the poor.

Florida also is the lead plain­tiff and home to the court of orig­i­nal ju­ris­dic­tion in the 20-state fed­eral law­suit to block the re­form law’s man­date to carry in­surance.

Scott did not win by a ma­jor­ity in Florida.

Kitzhaber was elected to a third term.

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