News from Tallahassee for 4/1/15

Florida senators meet with feds over health care money posted on 4/1/15

by GARY FINEOUT | AP

caduceusTALLAHASSEE, Fla. (AP) - Amid growing budget discord that could derail this year’s session of the Florida Legislature, Senate President Andy Gardiner dispatched two top Republican senators to Washington to talk with federal officials about more than $1 billion in health care grants the state could soon lose.

Gardiner, an Orlando Republican who works for a hospital, took the unusual step even as top officials with the administration of Gov. Rick Scott are directly negotiating with the U.S. Department of Health and Human Services and the Obama administration.

Tuesday’s visit by Sens. Rene Garcia of Hialeah and Garrett Richter of Naples comes as the House and Senate are prepared to vote this week on sharply divergent budgets that are more than $4 billion apart.

That’s because the Senate assumes that Florida will get billions in federal aid, including money the state could receive if it expands health care coverage to about 800,000 Floridians who are now ineligible.

The Senate has proposed accepting federal aid linked to President Barack Obama’s health care overhaul even though House Republicans have been adamantly opposed. That extra money could also help hospitals.

But federal officials have repeatedly emphasized that it would not renew a program where Florida receives extra money for its hospitals that treat the poor and uninsured. The uncertainty about whether the feds might renew the hospital funding - called the “low income pool”- in another form has left lawmakers in limbo.

Gardiner insisted that senators weren’t bypassing the Scott administration and said they were “not negotiating anything” with the federal government. But he said that, with time running out in this year’s session, talking directly with federal officials was the “prudent thing to do.”

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Abortion Restriction Bills Moving Forward posted on 3/31/15

by AP

The Florida Legislature is considering several new measures to restrict abortions, including one with a strong chance of passage that calls for a 24-hour waiting period before a woman can undergo the procedure.

That measure, HB 633, would require that a woman make one trip to the clinic for legally required counseling before coming back 24 hours later for the procedure. Another measure, HB 147, with less chance of passage, would require that abortion clinic doctors have admitting privileges at a hospital within 30 miles.

Waiting periods and admitting privileges have been part of unsuccessful Florida legislation in past years, but not as separate bills.

Abortion opponents say the measures are intended to safeguard women's health, but some acknowledge that restricting access and cutting the number of abortions is one goal...

Along with waiting period and admitting privileges bills, there is the "Florida for Life Act," a ban on most abortions that would challenge the U.S. Supreme Court's Roe v. Wade decision legalizing abortion. Rep. Charles Van Zant, R-Keystone Heights, has introduced the bill, HB 247, every year since 2010, but even anti-abortion forces don't consider it feasible.

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Weekly Roundup: Temperatures Rising as Budgets Unveiled posted on 3/23/15

by BRANDON LARRABEE | News Service of Florida

Things are getting warmer in Tallahassee -- and while the mercury is rising sharply, the hottest thing in town could soon be the battle over the shape and size of the budget for the coming year.

On Friday, the House and Senate unveiled spending plans for the year beginning July 1 that were similar in some respects and vastly different in others. The most striking area of conflict was the bottom line. An austere House budget would spend $76.2 billion -- less even than the almost $77 billion plan that Gov. Rick Scott proposed.

The Senate, on the other hand, made it rain, unveiling an $80.4 billion budget that would be the largest in state history and would include funding for a quasi-Medicaid expansion and a reconfigured Low Income Pool program. Those responsible for the upper chamber's proposal played down the significance of its size.

"Absent an additional $5 billion in local and federal funding, our proposed budget is approximately the same as the initial budget the Senate passed last year," Senate Appropriations Chairman Tom Lee, R-Brandon, said in a statement accompanying the budget. "This conservative approach preserves the resources necessary to address a crisis in Florida’s hospital network."

There are other differences in the plans -- the Senate's focus on health care comes even as it provides fewer dollars than Scott or the House in per-student funding for public schools. Neither the House nor the Senate would reach Scott's recommendation for school spending under the main formula used to bankroll elementary and secondary education.

Those disputes could lead to a climate change in what has so far been a mundane legislative session -- a change that would make it almost as heated inside the Capitol as April in Tallahassee promises to be outdoors.

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Health Expansion, LIP Program Divide Budget Proposals posted on 3/20/15

by JIM SAUNDERS | NEWS SERVICE OF FLORIDA

caduceusIn a move that creates a $5 billion divide with the House, the Senate released a budget proposal Thursday that banks on expanding health-care coverage for low-income Floridians and extending a critical funding program for hospitals.

The Senate proposal, approved by a key budget panel and touted by President Andy Gardiner, reinforces that health-care funding could be the most-vexing issue facing lawmakers during the rest of this year's legislative session.

Senators included $2.8 billion in the budget proposal to pay for an expansion of health-care coverage that is an outgrowth of the federal Affordable Care Act, better known as Obamacare. House Republican leaders have rejected such proposals during the past two years --- and have shown no willingness to go along with a revised Senate expansion plan this year.

If the expansion ultimately is approved, the federal government would cover the $2.8 billion first-year costs of the plan, which the Senate has dubbed the Florida Health Insurance Affordability Exchange Program, or FHIX.

The Senate budget proposal also includes nearly $2.2 billion for the continuation of the Low Income Pool program, which in recent years has funneled additional money to hospitals and other health providers that serve large numbers of poor and uninsured patients. The program, known as LIP, is scheduled to expire June 30 unless the state can reach agreement with the federal government on an extension. Amid such uncertainty, a House budget proposal released this week did not include the money.

Senate Health and Human Services Appropriations Chairman Rene Garcia, R-Hialeah, said the Senate has put together a revised formula for distributing the LIP money to hospitals. Garcia, whose subcommittee approved the budget proposal Thursday, said he hopes the formula would address concerns raised by the federal government about the program.

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Senate digs in on health expansion; huge budget differences with House posted on 3/19/15

by john kennedy | Palm Beach Post

FL Sen Rene Garcia

A Senate budget panel Thursday raised the stakes on that chamber’s duel with the House over health insurance for low-income Floridians and aid to hospitals.

Health and Human Services Appropriations Subcommittee Chair Rene Garcia, R-Miami, said he is building a budget plan that anticipates Florida receiving almost $2.2 billion in federal aid for hospitals serving uninsured patients.

The panel also will include in its budget another $2.8 billion representing the first year of federal cash coming from the Senate’s proposal to create a new Florida Health Insurance Exchange (FHIX).

“We can no longer wait for Washington,” Senate President Andy Gardiner, R-Orlando, said in a Thursday memo to senators.

“We must advocate for our own pro-active, market-based, Florida-driven solution for the enormous health care challenges facing our state. I look forward to your continued input and assistance with this important issue,” Gardiner said.

House Speaker Steve Crisafulli, R-Merritt Island, has shrugged off the Senate’s FHIX proposal, which would seek to win approval from the Obama administration to draw $50 billion in federal funding over the next decade.

Some 800,000 low-income Floridians could gain health insurance under the plan, basically the same population served if Florida joined more than two-dozen other states that have expanded Medicaid under the Affordable Care Act.

While funding for the private-insurance driven FHIX is not in the House budget blueprint, neither is the federal aid to hospitals. The federal Centers for Medicare and Medicaid Services has already told the state it intends to change this so-called Low Income Pool (LIP) but it’s unclear what effect that could have on funding.

Gardiner has said he fears the roughly $2 billion hospitals received this year will disappear. Crisafulli said he still holds out hope for some cash, and is joined by fellow Republican, Gov. Rick Scott, in rejecting the concept of expanding health coverage.

At the very least, the competing approaches set the stage for some budget chaos between the House and Senate.

The Senate appears on track to release a state budget proposal in coming days that may be $5 billion bigger than the House’s approach, which is likely closer in size to Florida’s current, $77 billion spending plan — the largest in state history.

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