News from Tallahassee for 5/24/15

Scott Heads To Washington To Talk LIP Funding posted on 5/6/15

by BRANDON LARRABEE | News Service of Florida

fl gov rick scottSetting off for Washington, D.C., to meet with federal officials over health-care money at the heart of a state budget crisis, Gov. Rick Scott on Tuesday flatly ruled out a Senate plan to extend private insurance coverage to hundreds of thousands of lower-income Floridians.

Scott, who once supported Medicaid expansion, said last month that he now opposes a Senate proposal to use expansion dollars for the private insurance plan. But his remarks to reporters on what he would tell federal officials about the Senate initiative marked his strongest rejection yet.

"It's not going to happen," Scott said. "There's no support in the House. I'm not going to support it. It's not a program that's worked."

Scott is expected to meet Wednesday in Washington with Sylvia Burwell, secretary of the U.S. Department of Health and Human Services, about the $2.2 billion Low Income Pool, or LIP, program, which is scheduled to expire June 30. The program sends money to hospitals and other health providers that care for large numbers of low-income residents, and uncertainty about its future has played a major role in a budget impasse between the Senate and House.

The governor spoke repeatedly Tuesday about getting Burwell to "reconsider" a decision on the Low Income Pool, even though Burwell's department has not made a final decision on the program. While the Centers for Medicare & Medicaid Services, which Burwell oversees, has said the future and funding level of LIP would be tied to whether the state expands Medicaid, federal officials can't legally rule on Florida's request for LIP funding until early July.

Scott and Attorney General Pam Bondi have filed a lawsuit to try to force the Centers for Medicare & Medicaid Services to stop linking the LIP decision and the state's intentions on Medicaid expansion. Senate leaders reject the notion that they want to expand Medicaid, but their private-insurance plan would rely on federal funding and would serve the same population as a Medicaid expansion envisioned in the federal Affordable Care Act.

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Gov. Rick Scott leaves meeting with HHS Secretary Burwell empty-handed posted on 5/6/15

by alex leary | tampa bay times

fl gov rick scottWASHINGTON, D.C. — Gov. Rick Scott's trip to Washington D.C. in search of a way to plug Florida's hospital funding shortfall didn't pay off.

Scott met with U.S. Health and Human Services Secretary Sylvia Burwell this morning to talk about renewing a $2.2 billion hospital funding program for Florida. HHS has told Florida the program is being phased out.

Afterward, Scott told reporters "we don't have a resolution" to the funding dispute,

Florida lawmakers have been unable to agree on how to plug the gap left by ending the Low Income Pool (LIP) program or whether to endorse a Medicaid expansion, a conflict that led to the abrupt end of the Legislature's regular session a week ago. The state has not yet approved a budget for its fiscal year beginning July 1.

"Now we're in a time crunch," Scott said. "If we don't have an answer our only solution is a base budget. That's what I'm working on now, is to make sure that we keep government working. Let's remember, this started with a federal government program for low-income families. Low income families deserve to have an answer."

Scott and Burwell's session had the potential to be awkward. After all, the governor is suing her. Burwell is named as a defendant in Scott's recent suit alleging that the Obama administration is trying to force Florida into expanding Medicaid by ending the LIP program.

"The federal government shouldn't be trying to coerce us to expand Obamacare with an existing program at they started," Scott told reporters Wednesday, echoing a theme of his lawsuit.

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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.

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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.

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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.

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