News from Tallahassee for 4/21/15

Special session expectations growing posted on 4/17/15

by bill cotterell | Tallahassee Democrat

When the first session under Republican rule ended, House Speaker Daniel Webster and Senate President Toni Jennings sat at a tiny table in the Capitol rotunda and Gov. Lawton Chiles poured orange juice for their toast to a new political era.

It wasn’t that everybody agreed with the two Orland Republicans presiding over the Legislature. It was that Webster and Jennings agreed work days would end at 6 p.m. and sessions would end on time.

And since that all-smiles celebration of 1997, lawmakers have pretty much finished their sessions on time. Long gone are the days of Democratic dominance when “sine die” meant convening at 7 a.m. and working past midnight as legislative “trains” of big issues were strung together – often including hand-written amendments that were literally run between House and Senate and voted upon unread by most members.

One session, with the June 30 end of the fiscal year looming, agencies made up lists of “non-essential state employees” who could be furloughed if the session ended without a budget. Technically, it did, although Chiles accepted a deal in the wee hours and everybody came to work the next day.

Late in a session, when somebody offered a bill or amendment that was sure to upset delicate deals worked out by all sides, Senate President Verle Pope of St. Augustine would warn, “I want y’all to come to our watermelon-cutting on the Capitol lawn, come Fourth of July” – because they were probably going to be in town all summer. But somehow, things got worked out and, except for some all-nighters or weekend work, sessions ran little more than the constitutionally allotted 60 days.

There are always dire predictions of overtime at this time of year, as each side uses the clock to force overtime. But this year, with the House and Senate $4 billion apart on the budget and Gov. Rick Scott planning to sue the federal government over health-care funding, it appears less likely every day that the Republicans can keep their record of business-like efficiency.

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Lawmakers likely to end session without deal on health care posted on 4/16/15


FL Capitol RotundaTALLAHASSEE, Fla. (AP) -- Saying that "sand is running out of the hourglass," the Republican leaders of the Florida Legislature said Wednesday that it appears they will end their annual session on May 1 without reaching a deal on health care and a new state budget.

The House and Senate are $4 billion apart in rival budgets and the leaders of the two chambers remain at an impasse over how to bridge the gap, which stems from a deep divide over whether to accept billions in federal aid to expand Medicaid. Medicaid expansion is linked to the federal health care overhaul pushed by President Barack Obama and is opposed by House Republicans.

"We're not willing to move away from our stated position," said a defiant House Speaker Steve Crisafulli, a Merritt Island Republican.

Top Republicans acknowledged that they will probably have to hold a special session to pass a budget. Part of the problem is that while the session ends on May 1, the state constitution requires that the budget be finished and on legislators desk 72 hours in advance.

The acknowledgement that time is short for the regular session came during yet another day of finger-pointing between the House, Senate, the administration of Gov. Rick Scott and the federal government.

Florida is in danger of losing more than $1 billion in federal hospital funding - a loss that state senators say would result in devastating cuts to hospitals, including hospitals that serve children. Federal officials say they want Florida to consider expanding its Medicaid program to 800,000 Floridians as part of any deal to keep the hospital money intact.

On Wednesday, U.S. Sen. Marco Rubio and five GOP federal lawmakers sent federal health officials a letter asking them to release the funding that helps hospitals care for low-income patients.

The letter states that federal officials "should not destabilize, eliminate or hold these programs hostage to an expansion decision" and should treat Florida no differently from California, a state that expanded Medicaid and was also granted federal hospital funds.

State health officials also chimed in. In a letter Wednesday to the Centers for Medicare and Medicaid Services, they warned that a 2012 U.S. Supreme Court decision said states could not be coerced into expanding Medicaid.

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Scott to sue feds over hospital funding posted on 4/16/15


Republican Gov. Rick Scott plans to sue the federal government for allegedly coercing Florida to expand Medicaid, his office said Thursday.

"It is appalling that President Obama would cut off federal healthcare dollars to Florida in an effort to force our state further into Obamacare," Scott said in a statement.

The announcement is but the latest round in an ongoing spat between Scott and the feds.

It centers around a $2.2 billion program known as the Low Income Pool, which provides funding to hospitals that treat uninsured patients. The program is scheduled to expire in June, unless the state and federal government can negotiate a successor program.

Despite weeks of negotiations, no deal has been reached.

In a letter Tuesday, the federal agency handling the negotiations told Florida's Agency for Health Care Administration that any decision regarding LIP would be linked to whether the state uses federal money to expand health care coverage.

Scott said the action violated a U.S. Supreme Court ruling "that the president cannot force Medicaid expansion on states."

"Not only does President Obama’s end to LIP funding in Florida violate the law by crossing the line into a coercion tactic for Obamacare, it also threatens poor families' access to the safety net healthcare services they need," Scott said.

He called the actions "outrageous and specifically what the Supreme Court warned against."

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Feds Officially Link LIP Talks to Medicaid Expansion posted on 4/15/15

by matt dixon | Tribune/Scripps Capital Bureau

CaduceusTALLAHASSEE — Federal officials announced Tuesday that ongoing negotiations with Florida leaders over $2.1 billion in hospital funding are tied to the state's willingness to expand Medicaid under President Barack Obama's health care law.

The announcement puts more pressure on Republican opponents of Medicaid expansion under Obamacare, which include the House Republicans and Gov. Rick Scott. They fear that the federal government may not cover all promised costs and the state cannot afford additional expenses to cover health care for the poor. The House and Senate budgets are at odds by more than $5 billion because of the split over health care funding.

The letter from federal officials comes after the state's attempts to continue talks last week were ignored by the feds, according to emails obtained by the Daily News/Tribune Capitol Bureau.

At issue is Low Income Pool [LIP], a pot of federal and local funds used by hospitals to provide charity care to low-income and uninsured patients. Federal officials must approve the money, which is now clearly contingent on the state expanding health care.

"We articulated to the state that we believe the future of LIP, sufficient provider rates, and Medicaid expansion are all linked in considering a solution for Florida," read the letter, sent from Vikki Wachino, acting director for the U.S. Centers for Medicare and Medicaid Services.

That link had been denied by GOP opponents of health care expansion. They continue to argue that the two issues should be considered separately...

In her letter, Wachino said she was "encouraged" by a Senate-crafted plan that would bring Medicaid coverage to an additional 800,000. The CMS letter came after federal officials brushed off attempts last week from state health officials to continue negotiations, according to emails.

On April 1, Florida Agency for Health Care Administrator Liz Dudek, a Scott appointee, said the feds put a "sudden" halt to LIP negotiations after Elliot Fishman, the top federal negotiator, took a two-week vacation.

On April 2, the federal Medicaid office issued its own statement contradicting the state agency. The federal statement said talks were still ongoing, and negotiations had not been halted.

But emails show that on at least two occasions, Justin Senior, the state's top Medicaid official, reached out to federal officials about the negotiations since that time, but received little response.

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Feud between state Senate, Gov. Scott boils over posted on 4/13/15

by Gray Rohrer | Orlando Sentinel

FL Gov Rick ScottTALLAHASSEE — Gov. Rick Scott headed for California on Sunday for a two-day mission to lure jobs to Florida, leaving behind a seemingly intractable budget battle and a growing rift between his administration and the Florida Senate.

The feud between Scott and the Senate blew out into the open last week, with Scott blaming senators for sabotaging his Medicaid negotiations with the federal government, and senators publicly scolding his agency heads.

The main source of the disagreement is over Medicaid. Scott is negotiating with the federal government to extend the Low Income Pool, a $2.2 billion Medicaid program paid with county and federal funds for health care for low-income and uninsured patients.

When the program was extended last year, the federal Center for Medicare and Medicaid Services said it wanted to see changes and wouldn't extend it in its current form.

But after Sens. Rene Garcia, R-Miami, and Garrett Richter, R-Naples, recently met with CMS officials to present their alternative LIP program, Scott says negotiations came to a halt, although federal officials dispute that.

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