Senate advances a revised Medicaid expansion plan

/

TALLAHASSEE

By LLOYD DUNKELBERGER
H-T Capital Bureau

TALLAHASSEE — Trying to find middle ground heading into next week’s special session, the Florida Senate on Tuesday advanced a revised health care coverage plan for some 800,000 Floridians, eliminating a requirement that those low-income Floridians first enroll in a Medicaid program.

In an attempt to win support from the House and Gov. Rick Scott, who have staunchly opposed Medicaid expansion, Sen. Aaron Bean, R-Fernandina Beach, filed legislation that would use federal funding to help Floridians purchase private insurance either through a state program, known as the Florida Health Insurance Affordability Exchange (FHIX), or through the federal health insurance exchange beginning Jan. 1.

“Our compromise solution completely eliminates phase one enrollment in Medicaid for every single person within the expansion population while preserving access to plans on the federal exchange,” said Bean, who chairs the Senate Health Policy Committee, which will take up the revised legislation (SB 2A) on Monday.

Scott though on Tuesday reiterated his criticism of the Senate plan as an expansion of “Medicaid under Obamacare (that) will cost Florida taxpayers $5 billion over 10 years.” Scott also re-emphasized his call for $673 million in tax cuts, which Senate and House leaders say will be part of the special session debate.

The Senate legislation, which will be considered in the 20-day special session that begins Monday, also revised provisions requiring participants to have a job or to be looking for work or to be enrolled in training or education programs.

House Speaker Steve Crisafulli, R-Merritt Island, expressed skepticism about the federal government approving the revised version of the Senate plan — particularly the work requirement.

“The new version of FHIX still requires a waiver from the inflexible federal government and adds new elements to that waiver request, a request we know will never be approved,” Crisafulli said in a statement. “When you remove the Senate’s ‘conservative guardrails’ that the Obama administration fundamentally opposes, all you are left with is a costly and inefficient entitlement program to serve able-bodied working age adults with no children.”

Crisafulli said the state would be better off developing its own coverage plan without federal participation.

Like its previous version, the FHIX plan requires participants to pay a modest premium for coverage, ranging from $3 a month to $25, depending upon their income level, which must be below 138 percent of the federal poverty level.

The measure would also give the Legislature the ability to opt out of the plan if the federal government later substantially changes it

The most significant change is the Senate decision to eliminate moving the new participants initially into the state’s Medicaid managed care. However, the health care expansion plan would still be funded — assuming federal approval — through the Affordable Care Act, with the federal government picking up its entire cost in 2016 but gradually decreasing its support to 90 percent by 2020.

“Does it include federal dollars? Yeah, it does. But I also think it’s a good free market approach and it’s a Florida solution to what we can actually pass in Florida,” said Senate President Andy Gardiner, R-Orlando, noting Florida already relies on billions of dollars in federal funding for the existing Medicaid program as well as a host of other state programs, including transportation.

Gardiner also defended the Senate proposal to require participants to be working or training for jobs. “I would say let’s find out,” Gardiner said about the potential of the federal government rejecting the idea. “What we’re trying to do is a Florida solution to this situation.”

Gardiner said the Senate continues to maintain that Florida’s best option — given current federal policies — is to try to expand health care coverage for low-income residents given the eventual demise of a $2.2 billion federal hospital funding program.

State officials learned last week that the $2.2 billion program, known as the Low Income Pool, will likely drop to $1 billion in the coming year, with its full elimination in two years. “We feel a long-term solution is still the best decision to be made,” Gardiner said.

Although they are not in agreement on the actual bills, House and Senate leaders have each said they would consider health care legislation being advanced by each chamber in the upcoming special session. Gardiner said he is pleased the Senate FHIX plan will get a hearing in the House, and said House proposals aimed at cutting health care costs would get a hearing in the Senate.

“We’re grateful that the House has started this dialogue with us,” Gardiner said. “We look forward to the discussion and debate and we’ll see what happens next week.”

Gardiner said he and House Speaker Crisafulli are in agreement that lawmakers must come to terms on a new state budget in the special session, regardless of what happens to the health care legislation.

“You could have a scenario where no health care bills get done and you do a budget and you go home,” Gardiner said. “But I have confidence in the Senate that they will be able to address all these issues and figure it out.”

The Senate-House divide over health care funding — essentially the House’s opposition to the Senate’s original Medicaid expansion plan — created a $4 billion budget impasse during the 2015 regular session.

Lawmakers begin their special session next week under the deadline of having to approve a new state budget or face a state government shutdown on July 1.

avatar

Lloyd Dunkelberger

Lloyd Dunkelberger is the Htpolitics.com Capital Bureau Chief. He can be reached by email or call 850 556-3542. ""More Dunkelberger" Make sure to "Like" HT Politics on Facebook for all your breaking political news.
Last modified: May 26, 2015
All rights reserved. This copyrighted material may not be published without permissions. Links are encouraged.