News from Tallahassee for 3/27/15

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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Health Expansion Moves On in Senate posted on 3/18/15


caduceusDefending the possible acceptance of billions of dollars in federal money, a Senate panel Tuesday unanimously approved a plan that would extend health-care coverage to about 800,000 low-income Floridians.

The plan (SB 7044), backed by the Senate Health and Human Services Appropriations Subcommittee, appears to be moving quickly in the Senate. But House Republican leaders, who for the past two years have flatly rejected accepting federal money to expand coverage through Medicaid or another program, have given no indication they will go along with the Senate.

Before Tuesday's vote, the conservative group Americans for Prosperity and the National Federation of Independent Business echoed concerns about accepting federal money as they argued against the Senate coverage plan.

"We don't believe that we should be accepting these federal funds and, two, we view this as a state's rights issue,'' said Skylar Zander of Americans for Prosperity. "We believe that a bureaucrat in Washington, D.C. can change something at the change of a wind or getting the wrong signal from a congressional member that says otherwise, and then we have to come back to the drawing board and rewrite this and go through this entire process again."

But senators pointed to the state's longstanding acceptance of federal money for health care, education and transportation and said the prospect of federal funding is not a reason to vote against the coverage expansion. Health and Human Services Appropriations Chairman Rene Garcia, R-Hialeah, said an analysis showed about a third of Florida's budget relied on federal money.

"Without the federal government, we would have a Mad Max Florida,'' said Sen. Joseph Abruzzo, D-Boynton Beach. "It would be out of control."

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FL No. 2 in National Uninisured Rate posted on 3/18/15

by AP

Florida ranks No. 2 in the nation in the rate of residents without health insurance, but that figure has declined since 2010.

Figures released by the U.S. Census Bureau on Tuesday show that Florida had an uninsured rate of 24.3 percent in 2013. Only Texas had a higher rate at 24.8 percent.

The lowest rate was 4.3 percent in Massachusetts.

Despite the high ranking, Florida's uninsured rate has declined since 2010 when it was 25.3 percent.

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Medicaid expansion threatens to divide Florida GOP’s harmonic session posted on 3/16/15

by john kennedy | Palm Beach Post

TALLAHASSEE — With a $1 billion budget surplus, low-key legislative leaders and a Republican governor just re-elected to a second term, the Capitol looked like a place where harmony could reign this spring.

But Senate President Andy Gardiner’s push to expand health insurance for low-income Floridians has suddenly driven a wedge between Florida’s Republican leaders as the legislative session enters its third week.

“It’s an intellectual battle,” said Rep. Richard Corcoran, R-Land O’Lakes, a top deputy to House Speaker Steve Crisafulli, R-Merritt Island, who, like Gov. Rick Scott, says he has no interest in any form of Medicaid expansion.

Still, this mind game will continue to play out on paper in coming days as the House and Senate begin building vastly different state budget proposals. The Senate plans to include millions of dollars in anticipated federal funding for the new health-care coverage.

Without it, Gardiner, R-Orlando, has said Scott’s bid for $673 million in tax cuts and a record level of classroom funding could be in jeopardy.

“If you look at the lay of the land right now, there’s a chasm there…that might be too big to bridge,” Corcoran said. “But there’s a lot of session left.”

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Telemedicine Gets A Bi-Partisan Boost In First House Hearing posted on 3/16/15

by Lynn Hatter | WFSU

If you can’t get to the doctor, it could become easier for the doctor to come to you. That’s the point of telemedicine, which connects physicians to patients through video conferencing. A compromise worked out with various hospitals, and physician organizations has cleared the way for a telemedicine proposal to get through the legislature.

During a press conference last month at the Capitol, Sen. (R-Jacksonville) joined other lawmakers from both parties and both houses—in a show of unity for a bill to finally put telemedicine in state law.

“We are delighted, we’ve got a team as we celebrate the launch to bring telemedicine to Florida. It’s been here a long time, but to codify it in law is a big deal," he said.

Most of the opposition for the past several years has come from the Florida Medical Association. The powerful physician lobby group has demanded only Florida doctors be allowed to treat Florida patients.

“We’re a state of 19.2 million people, it’s hard to get everybody 100 percent," Bean said, when asked whether the FMA had shown any support for the plan.

During the House telemedicine bill’s first appearance Thursday, all the medical-based organizations in attendance, backed the proposal. Including the FMA's Jeff Scott, who gave the proposal a thumbs-up.

“We support this bill. And I’d like to thank Rep. Cummings and Rep. Jones for working with us and having the patience to go through some of the problems we’ve addressed, and took a lot of time to address our concerns and let us know they’re not so concerning.”

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