A Senate panel Tuesday unexpectedly rejected Gov. Charlie Crist's hand-picked chief to oversee the state's $19 billion Medicaid program. The Health Regulation Committee's 4-3 vote against Tom Arnold's confirmation as secretary of the Agency for Health Care Administration stood out because such rejections are exceedingly rare and the career bureaucrat had few enemies in the Capitol. The senators complained that Arnold's agency did not do enough to manage Medicaid contracts and rein in fraud, estimated at $2 billion. But most of the problems with Medicaid preceded Arnold—who was appointed in October—leading to speculation that, for some, politics were also at play in the Senate.