News from Tallahassee for 5/4/15

House Packet on Medicaid Called Misleading posted on 4/30/15

by Carol Gentry | Health News Florida

Florida House leaders, who for three years have rejected federal funds to expand health coverage to the poor, brought the legislative session to an early halt Tuesday because of their rock-solid belief that “Medicaid is broken.”

This strongly held position is not new. It developed in the past when doctors shunned Medicaid because of low pay rates. Even as Medicaid has been transformed and turned over to the private sector, the attitude has persisted and intensified among groups opposed to the Affordable Care Act and all its parts, including Medicaid expansion.

Last week, the position appeared in materials distributed at a Florida House Republican caucus held behind closed doors. They contain data that appear to provide a scientific case against Medicaid expansion and the Florida Senate proposal to accept $2.8 billion in federal funds to cover 800,000 low-income uninsured next year.

Health News Florida received a copy from the House Majority Leader’s office, asked for feedback on it from two well-known Medicaid researchers from the Georgetown University Health Policy Institute and the Henry J. Kaiser Family Foundation.

Both organizations are non-partisan and neutral on health policy matters. Joan Alker, director of the Georgetown Institute’s Center on Children and Families, has written that she hopes that Florida will cover the uninsured, but has taken no position on specific legislation.

Both Alker and Rachel Garfield, associate director of the Kaiser Commission on Medicaid and the Uninsured, said the GOP packets contained cherry-picked studies that, put together, appear to cast doubt on Medicaid’s effectiveness. The studies were not flawed, they said, but there was a heavy spin on the conclusions.

Alker said there were “so many inaccuracies and misperceptions” within the House arguments that “really it would take too long to address them all.” She and Garfield provided widely accepted studies to explain their point.

Here are some discoveries.

» Read more

Scott Files Lawsuit Over Medicaid Expansion posted on 4/29/15

by AP

Florida Gov. Rick Scott sued the Obama administration Tuesday, charging that federal officials are coercing the state to expand Medicaid in order to get $1 billion in federal hospital funds.

The Republican governor points to a 2012 U.S. Supreme Court decision saying the federal government can't coerce states to expand Medicaid, which is exactly what he says the Obama administration is doing by withholding hospital funds.

"President Obama's sudden end to the Low Income Pool (LIP) health care program to leverage us for Obamacare is illegal and a blatant overreach of executive power," Scott said in a statement.

But legal experts say that Supreme Court case doesn't necessarily apply. That's because the hospital funds Scott wants are part of an optional program, and the federal government has broad discretion over it.

The lawsuit was filed in a Pensacola federal court - the same place where Florida previously challenged the health care law. The Sunshine State filed the first lawsuit against the Affordable Care Act and was eventually joined by about two dozen other states.

Attorney General Pam Bondi's office hired outside attorney Paul Clement, who successfully argued that the Obama administration could not coerce states into Medicaid expansion. Clement was solicitor general under former President George W. Bush.

Republican Texas Gov. Greg Abbott has said Texas will support Florida in its litigation.

Only eight other states get the LIP hospital funding. Florida's is the first to expire on June 30th but other states are watching closely as the federal government has said the guidelines it uses to decide in the Florida case will be used in other states.

» Read more

Statewide Hearings on LIP Start In Orlando posted on 4/29/15

by abe aboraya | WMFE

For the first time today, the public will get to weigh in on what to do with a federal program for the uninsured that’s created gridlock in Tallahassee. The Wednesday meeting in Orlando kicks off a series of statewide hearings on the Low Income Pool, or LIP.

LIP is a $2.2 billion dollar fund that mostly reimburses hospitals for treating Floridians without health insurance. It expires this summer, and federal officials aren’t inclined to extend it, saying instead the state should expand Medicaid to an additional 800,000 Floridians.

Gov. Rick Scott has threatened a lawsuit over the issue, and lawmakers are in gridlock over how to pay for coverage of the uninsured.

House Speaker Steve Crisafulli sent an offer to the Florida Senate that would put $600 million of general revenue to draw down another $900 million in LIP funding – but only if the Florida Senate gave up a proposal to expand Medicaid. The senate wants to expand Medicaid by creating an insurance marketplace for the state.

That offer is no longer on the table, and the Florida house adjourned early Tuesday without passing a budget.

Florida Agency for Health Care Administration Secretary Elizabeth Dudek said the meetings are planned in Orlando, Miami and Tallahassee.

» Read more

Why did the Florida House adjourn early? Answering your questions posted on 4/29/15


TALLAHASSEE— It’s no longer a debatable claim to say that the 2015 legislative session has ventured into uncharted territory.

The session jumped off the rails at 1:15 p.m. Tuesday when Florida House Speaker Steve Crisafulli, R-Merritt Island, told his 119 colleagues in the lower chamber that they were done and could go back home three days before Friday’s scheduled end date. The Senate, caught off guard, now plans to finish up Wednesday.

It’s the first time since the Legislature started keeping records that the chambers will end regular session on different days.

So how did we get here? Where are we going? We may not know for some time, but here is a guide.

What happened?

The Florida House and Senate couldn’t negotiate the one piece of legislation they are required to pass: a state budget. The House passed its $76.2 billion budget plan April 2, but it didn’t include $4 billion that was included in the Senate’s budget, which had passed hours earlier. For a month, the two chambers have not been able to agree on how to bridge that $4 billion gap.

» Read more

Gardiner: Send Full FHIX Plan to Feds posted on 4/28/15

by Carol Gentry | Health News Florida

Florida Medicaid’s request that federal officials send the state $2.2 billion dollars to keep the Low Income Pool subsidies flowing to hospitals won’t work because a vital part is missing, Florida Senate President Andy Gardiner says.

The missing link, he said, is the Florida Health Insurance Affordability Exchange, known as the FHIX. It is the Senate’s plan to cover up to 1 million of Florida’s low-income uninsured residents by accepting billions of dollars in Medicaid expansion money under the Affordable Care Act.

Gardiner’s letter, released around noon Monday, urges Medicaid Director Justin Senior to send federal officials the Senate’s FHIX plan right away to meet the guidelines set down by the Centers for Medicare and Medicaid Services (CMS).

Without expanded coverage, Gardiner wrote, “the state may not be successful” in its quest for the LIP funds. The LIP program, part of a 2005 waiver, expires June 30.

It would be a surprise if Gardiner’s request were granted. The Medicaid program, part of the Agency for Health Care Administration, answers to the governor’s office. And Gov. Rick Scott, like the Florida House, currently opposes taking the Medicaid expansion money.

The ensuing stalemate over the federal money has prevented the House and Senate from reaching an agreement on the budget, which needs to be on legislators’ desks on Tuesday in order to end the session on time this Friday.

» Read more

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