The Governors support for Medicaid expansion in Florida is a positive development but no done deal. The Florida House and Senate will have to reconcile their different political and ideological views regarding this issue. Meanwhile, Florida also won its request from the federal government for a waiver granting a statewide expansion of the Medicaid Managed Care Program. That means that Medicaid recipients will be coerced to join managed care companies which will receive state and federal funding to run the Medicaid program. Unfortunately, this is not only bad news for Floridians who will now routinely experience service denials and rationing of care but even worse news for participating doctors and other healthcare providers. Already primary care physicians receive reimbursements as low as $15 per patient to care for complicated chronic diseases and are being forced to manage those patients 24/7. These sweat shop conditions are being condoned by Florida Legislators who only consider the bottom-line: cheaper is better. Who is implementing and monitoring the necessary accountability and transparency measures to curtail managed care abuses? In the end we will create a new robber baron class; managed care company executive who are being showered with billions of federal dollars. Physicians and patients will be the recipients of trickle down healthcare economics. Who cares?