As I write this on Election Day, Florida’s gubernatorial race between incumbent Governor Scott and former Governor Crist appears to be one of the closest in the country. And Florida keeps popping up on lists of states for which the outcome of the Governor’s race will make a big difference.

Maybe, but I have my doubts. Scott, while supporting Medicaid expansion in theory, has done virtually nothing to move it forward in the legislature. Crist has made this a campaign issue and has been clear that he wants to push for expansion. So that’s the theory as to why the election is critical.

There are a few holes in this line of thinking. First, I am guessing that Crist, a former Republican, is NOT popular with the legislature, which is sure to remain Republican controlled. Whether the House, which has been the main source of resistance, would become receptive as a result of Crist’s pressure, seems questionable. And on the flip side, it’s possible that Scott has been lukewarm because he didn’t want to alienate his base in a tough reelection fight and may reconsider.

Which leads me to my main point. Call me a wonk, but I think the negotiations with the federal government about the future of Florida’s special hospital pot of $2 billion (known as the Low Income Pool or LIP) are more critical regardless of who is in the Governor’s mansion.

As I have blogged about before, CMS only extended this pot of hospital funding for one year through June 30, 2015, rather than the normal three year waiver extension. While the state has argued that the future of the LIP has nothing to do with Medicaid expansion, that doesn’t make any sense. The LIP is Medicaid money going to hospitals to help serve uninsured patients. If Florida expanded Medicaid, the state (and ultimately the hospitals) would receive more federal Medicaid money to provide coverage to uninsured Floridians that need it. So why would the Obama Administration continue this special deal for Florida – a deal that originated, by the way, when one Bush was President and his brother was the governor of Florida.

While CMS didn’t explicitly link the two issues in the extension letter, it seems clear to me reading between the lines that the unusual one-year extension was intended to precipitate some serious thinking in the upcoming state legislative session about what to do. And that will have to happen regardless of who is residing in the Governor’s mansion.