Herald-Tribune
” Scott reverses path on Medicaid”
April 6, 2015
By Lloyd DunkelbergerTALLAHASSEE – Complicating an already difficult legislative session in which lawmakers differ over $4 billion in health care funding, Gov. Rick Scott abruptly entered the fray Monday, all but declaring he would oppose any expansion of Medicaid this spring.

Scott’s statement shifts the session dynamic in favor of the House, which opposes expanding Medicaid under the federal Affordable Care Act.But the Senate is firm in its support for a $2.8 billion Medicaid expansion, which would provide health care coverage to some 800,000 low-income Floridians as part of an plan that includes $2.2 billion in hospital funding, which the House budget currently does not include.Senate leaders made it clear Monday that if the health funding issue is not resolved, it could jeopardize other session priorities, including the governor’s call for more than $600 million in tax cuts and higher spending on public schools.The latest development began when Scott issued a statement casting doubt on whether the federal Centers for Medicare and Medicaid Services (CMS) will reauthorize the so-called “low income pool (LIP)” for hospital reimbursements, which is set to expire July 1, to its current $2.2 billion level. Scott said it would be “hard to understand” how the state could take on another federal program like the Medicaid expansion that federal officials could also “scale back” in the future.”Our priority is to cut more than $600 million in taxes this session and get K-12 education funding up to record levels while holding the line on college tuition,” Scott said. “We still have several weeks left for budget negotiations.”However, given that the federal government said they would not fund the federal LIP program to the level it is funded today, it would be hard to understand how the state could take on even more federal programs that CMS could scale back or walk away from.”In 2013, facing a tough re-election fight, Scott surprised many by endorsing Medicaid expansion, although he did little to advance the issue. He repeatedly said he would support the expansion of the health care program for the poor and disabled as long as the federal government paid the entire cost.Now Scott says he is concerned that the federal government will not live up to its promise to underwrite the expansion of Medicaid for some 800,000 Floridians, as advanced in the Senate Medicaid expansion plan, which is known as FHIX.But federal officials immediately responded noting that the law requires the federal government to pay for the entire expansion through 2016, with the federal share gradually dropping to 90 percent by 2020.”The law is clear: federal funding for Florida’s Medicaid expansion covers 100 percent of the costs of newly eligible individuals through 2016 and will never fall below 90 percent,” said Ben Wakana, a spokesman for the U.S. Department of Health and Human Services, which oversees the CMS.Wakana also said federal officials see a connection between the Medicaid expansion and the renewal of some form of the LIP program.”(The federal government) has proven itself willing to work with any state interested in expanding Medicaid and we have consistently said that a Florida solution would reduce costs for hospitals that are typically passed on to taxpayers and expand access to quality health care for more Floridians,” Wakana said. “That’s a common sense path that’s good for taxpayers and the economy of the Sunshine State.”Senate President Andy Gardiner, R-Orlando, said the statements from the federal officials as well as information from U.S. Sen. Bill Nelson and other lawmakers indicate CMS “will not fund the LIP (hospital) program in its current form if our state does not also address coverage for the uninsured.”The Senate shares concerns raised by Gov. Scott and the Florida House regarding the federal government’s ability to fund an expansion of coverage for the uninsured,” Gardiner said. “For this reason, the … program authored by the Senate includes conservative guardrails that would bring the program to an end if the federal government fails to meet its obligations to Florida.”Gardiner also said if lawmakers are forced to make up a large portion of the current $2.2 billion LIP program, it will impact “every area of our budget,” including the tax cuts and education funding.Scott’s decision to rebuff any Medicaid expansion drew praise from Bob McClure, head of the James Madison Institute, a conservative think tank.”Gov. Rick Scott made the tough, but wise decision to see the writing on the wall with the political games being played with the (hospital) funding,” McClure said. “There is no short-term solution here, but Gov. Scott and many of Florida’s leaders recognize that the worst thing Florida can do is fall deeper into dependency on the shallow promises of the feds.”Rep. Mark Pafford, D-West Palm Beach, said House Democrats support the federal government and Senate position on Medicaid expansion.”We are glad to join with willing federal partners and a unanimous Florida Senate – in addition to business groups and hospitals who share the view,” Pafford said. “Existing plans to extend the opportunity for health care coverage to more than 800,000 Floridians are the right starting point.”With less than four weeks left in the annual session, the continuing differences over the health care funding has stalled any real negotiations over a new state budget, raising the likelihood that lawmakers will be forced into an extended or overtime session following their scheduled May 1 adjournment.Article: http://www.heraldtribune.com/article/20150407/ARCHIVES/504071052/-1/todayspaper?tc=ar