- Associated Press - Tuesday, April 7, 2015

TALLAHASSEE, Fla. (AP) - A growing standoff about health care is creating a divide between the Republican-controlled Florida Senate and Gov. Rick Scott.

A Senate panel Tuesday refused to confirm a top appointee of the Scott administration after he would not answer questions about whether he supported the Senate plan to expand health care coverage to 800,000 Floridians.

The move came a day after Scott said he could no longer support expanding Medicaid because of doubts about the federal government’s promise to pay for it.

The repeated refusal by state Surgeon General John Armstrong to answer several questions about the proposal, which is linked to President Barack Obama’s health care overhaul, frustrated both Republican and Democratic senators.

The move to delay a vote on Armstrong’s confirmation is just another sign of how the disagreement on health care is rippling through this year’s session. The House and Senate budgets are $4 billion apart because of the disagreement and there are no clear signs that legislators can bridge the gap between now and the scheduled session end date of May 1.

Senators say they are pushing the expansion proposal because of the expected loss of more than $1 billion in federal aid that now flows to the state’s hospitals to pay to treat the poor and uninsured. They say they cannot vote for a budget that would result in large cuts to hospitals.

“We’re not retreating from our position. We’re comfortable with what we put together,” said Senate Majority Leader Bill Galvano, R-Bradenton.

The federal Centers for Medicare and Medicaid Services warned a year ago that it would not renew the federal money known as the “low income pool.” Federal officials had been negotiating with the state on a revamped proposal but negotiations turned ugly last week, with the state sending a series of frenzied statements accusing the feds of walking away from the discussion while a key federal health official was on vacation. Federal health officials said they remain in contact with the state.

Scott put out a statement Monday saying the rift shows why Florida should not move ahead with expanding Medicaid. Talking to reporters a day later, Scott bluntly said: “Why would you trust them?”

Advocates say the hospitals wouldn’t need as much federal funding if the state expanded Medicaid because the hospitals would have more paying customers. The federal government has offered to pay the entire Medicaid expansion bill for the first few years, but Scott and House Republicans are concerned officials will renege. House Republicans also contend Medicaid is a broken system.

Galvano said the decision to delay the confirmation vote will give Armstrong time to “reflect” on whether expanding health care coverage would improve the overall health of Floridians. The Senate might reconsider Armstrong’s appointment next week.

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Follow Gary Fineout on Twitter: http://twitter.com/fineout

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