03/11/2013 04:09 pm ET Updated May 11, 2013

Florida Medicaid Expansion Hits Another Snag

Florida Gov. Rick Scott (R) may have taken a long journey from professional Obamacare antagonist to would-be Medicaid expander but he apparently didn't bring enough Republican state legislators along for the ride.

A Florida Senate committee voted to reject a Medicaid expansion to an estimated 1.3 million poor Sunshine State residents Monday. A Florida House of Representatives committee did the same thing a week ago.

To say this least, these are significant setbacks for Scott, who exposed himself to accusations of flip-flopping and broken promises when he announced his support for the Medicaid expansion last month. The legislature has until May 3 to make a final decision on Medicaid, according to Bloomberg News.

Medicaid expansion is exposing rifts between governors and state legislatures across the U.S. In some cases, it's simply a matter of partisan splits. In Maine, for example, Republican Gov. Paul LePage opposes the expansion but the legislature is controlled by Democrats, who generally back broadening health care coverage for the poor.

More interesting, perhaps, are those states like Florida where the battle is between Republican lawmakers and Republican governors working in common interest with pro-expansion Democrats. That's more or less the dynamic taking shape in Gov. Jan Brewer's Arizona and Gov. John Kasich's Ohio, for instance.

In most cases, the governors enjoy the support of influential health care industry forces that stand to gain from more people having health care coverage and from powerful business groups, like the Florida Chamber of Commerce, that favor the Medicaid expansion.

In Florida, the Senate panel plans to look into an alternative plan to add more poor people to private health insurance coverage using the federal Medicaid dollars, the South Florida Sun-Sentinel reports. Arkansas Gov. Mike Beebe (D) got tentative federal approval to propose just that to the Republican-led legislature in his state despite evidence that it would cost taxpayers more than simply enrolling people into Medicaid.