A battle is brewing here in Florida, where Gov. Rick Scott took to national television soon after the ruling to announce that he would reject the expansion. Mr. Scott describes Medicaid as a dysfunctional program, saying the portion of the state budget devoted to it is growing at more than three and a half times the rate of general revenues. Hospital associations around the country have already signed off on cuts to reimbursement rates under the healthcare law on the assumption that the new paying customers they would gain, partly through the Medicaid expansion, would more than cover their losses.