TALLAHASSEE, Fla. (AP) - Gov. Rick Scott reversed course Monday, saying he no longer supports Medicaid expansion as talks break down between Florida and its request for the federal government to extend funds to hospitals that serve low-income patients.
Scott wants the federal Centers for Medicare and Medicaid Services to give Florida about $1 billion in hospital funds, but federal officials have denied that request for about a year, standing firm that the funds will end June 30. Negotiations between state and federal health officials 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.
The negotiations over the hospitals funds, known as the low-income pool, have spilled over to Medicaid. Advocates say the hospitals wouldn’t need as much federal funding if the state expanded Medicaid to 800,000 Floridians 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.
Scott, who started his political career running TV ads against the federal health law, shocked many when he came out in support of Medicaid expansion in 2013 in an emotional speech, calling expansion a compassionate and common sense solution. But he’s backed away in recent years.
“Our priority is to cut more than $600 million in taxes this session and get K-12 education funding up to record levels while holding the line on college tuition. We still have several weeks left for budget negotiations; however, given that the federal government said they would not fund the federal LIP program to the level it is funded today, it would be hard to understand how the state could take on even more federal programs that CMS could scale back or walk away from,” Scott said in a statement.
The growing feud has flustered Tallahassee lawmakers as they try to finalize a new budget before the session ends May 1. The House and Senate are $4 billion apart, with the Senate including plans to take federal money to expand Medicaid.
Federal health officials stressed Monday that their funding will never fall below 90 percent and said they are eager to work with Florida to expand Medicaid or on an alternative solution that would help reduce hospital costs.
Senate Republicans crafted an alternative program that would take billions in federal funds so Medicaid recipients could purchase private insurance through vouchers.
The bill would offer coverage to adults aged 19 to 64 and who earn up to 138 percent of the federal poverty level, or about $33,000 for a family of four. The legislation would require enrollees to pay monthly premiums. It also requires participants to work or go to school.
Senate President Andy Gardiner countered that the proposal offers “conservative guardrails that would bring the program to an end if the federal government fails to meet its obligations to Florida.”
Senate leaders have warned they will not vote for a budget if it requires large cuts to hospitals. But House Republicans remain opposed to any expansion efforts.
“The governor may have some egg on his face, and I think it’s absurd to claim that the federal government has somehow not lived up to its bargain,” said House Democratic Leader Mark Pafford said, who is optimistic an expansion bill will be heard before session ends.
The news that Scott now has problems with Medicaid expansion didn’t surprise top senators.
Sen. Tom Lee, the Brandon Republican in charge of the Senate budget, held a nearly hourlong meeting last week with Scott, where the GOP governor talked about health care but didn’t discuss or show support for the Senate plan.
“It was clear to me that he wasn’t supportive of Medicaid expansion,” Lee said.
Lee and Senate President Gardiner said that if legislators don’t address health care funding issues, including the Senate proposal, it could make it difficult to find agreement on other issues that Scott wants passed.
“The Senate also shares the governor’s commitment to tax relief and record funding for education; however, if our state is forced to make up the difference of $2.2 billion in hospital funding, every area of our budget will be impacted,” Gardiner said.
Kennedy reported from Fort Lauderdale.
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