After years of vocal resistance, Florida Republican Gov. Rick Scott, one of the country's most outspoken critics of the Affordable Care Act, has acceded to one of the law's core provisions, agreeing today to expand Medicaid coverage to 1.3 million Floridians.

Scott, a former healthcare executive, started an advocacy group to fight the health law before being elected governor, and has continued fighting the law ever since. He joined with other Republican governors to oppose the ACA's Medicaid expansion, arguing that it would be too expensive for their states, and took his legal challenge all the way to the Supreme Court.

Advertisement:

But this afternoon, the federal government granted Florida's request for a conditional waiver to experiment with privatizing Medicaid in the state, and Scott quickly backed down on opposition to the expansion. He hastily called a press conference to formally announce the new policy this evening.

"I cannot in good conscious deny access to Floridians who need healthcare," he told reporters. However, he warned that his plan will only go ahead if the federal government funds 100 percent of the Medicaid expansion for the first three years, which will act as a probationary trial period. After that, the expansion will need to be reauthorized.

The Medicaid expansion was central to the Affordable Care Act's goal of providing universal healthcare to all Americans. It requires states to expand Medicaid coverage to anyone who makes 133 percent of the federal poverty level.

Advertisement:

And second only to the individual mandate, it attracted vociferous Republican opposition, much of it led by Scott. So it was odd to hear him defending the expansion as a wise and fiscally prudent move in his press conference today. "This is not a white flag of surrender to government-run healthcare," Scott explained. "We now have a Supreme Court decision and we have an election that says this is the law of the land."

Scott, now one of only about a half-dozen Republican governors who have agreed to the expansion, could face a Tea Party backlash.

Scott's privatization plan will expand on a five-county pilot program that has been "rife with problems," the Miami Herald reported. Critics worry the for-profit providers are putting profits above coverage, and some doctors and health plans have dropped out of the pilot program.