TALLAHASSEE
Florida hospitals are in the middle of the epic budget stalemate that could force lawmakers into an overtime session that could last well into June.
And they still do not have the answer to a $2.2 billion question.
That question hinges on a federal program known as the low-income pool (LIP) that provides $2.2 billion to Florida hospitals and other health care providers to offset their costs for uncompensated patient care.
The state submitted a formal request to extend the program on Monday. But federal officials at the Centers for Medicare and Medicaid Services may not have a formal answer on that LIP request before the new state budget year begins on July 1.
The Senate has advanced the Florida Health Insurance Exchange (FHIX) plan, a form of Medicaid expansion that would extend private health coverage to 800,000 low-income Floridians, as way to offset the possible loss of all or part of the LIP money.
But the FHIX plan is strongly opposed by the House and governor, who do not favor any form of Medicaid expansion under the federal Affordable Care Act. And that is the crux of the standoff between the House and Senate.
This week both the House and Scott, a former CEO of the Columbia/HCA hospital chain, raised new questions about hospital financing.
Scott called individual senators into his office to remind them of his veto power and to show them a six-page spread sheet highlighting Florida hospitals taking in $43 billion in revenue and having an operating margin in the range of 6.77 percent.
House Appropriations Chairman Richard Corcoran, R-Land O’Lakes, was equally blunt in turning up the heat on the hospitals.
“The entire fight is about paying hospitals more money. It has nothing to do with coverage or health care outcomes for the poor,” Corcoran tweeted on Wednesday.
Scott also said if lawmakers can’t reach a budget deal – which is now a certainty – by the May 1 deadline of their current session he may create a health care commission “to examine the revenues of Florida hospitals, insurance and healthcare providers and how any taxpayer money contributes to the profits or losses of these institutions in Florida.”
Scott said the commission could provide some recommendations as lawmakers continue their debate over hospital finances in an extended session as well as provide some analysis as the governor and Legislature develop another state budget next year.
It’s not the first time Scott has urged more scrutiny of hospitals that are tax supported or receive other types of public funding. Shortly after he took office in 2011, Scott created the Commission on Review of Taxpayer Funded Hospital Districts that probed hospital finances and required the hospitals to hold local hearings where the public could comment on their operations.
Sen. Alan Hays, R-Umatilla, said he met with Scott and has already volunteered to serve on the new commission. “(I) told him that I fully support his idea to form a commission to better understand the use of our tax dollars in the health care industry,” Hays said.
Hospital representatives said they are ready to justify their services and funding.
Tony Carvalho, head of the Safety Net Hospital Alliance, which includes Sarasota Memorial, UF Health Shands and Tampa General, said the hospitals “are critical to their communities by providing a disproportionate amount of uncompensated and Medicaid patient care.”
“The critical loss of LIP funding would put most of these providers at a significant risk,” Carvalho said. “It’s unfortunate the spreadsheet of hospital margins did not include data showing the impact of what would happen to hospitals and the Medicaid managed care system if LIP funding went away.’’
Ron Bartlett, a spokesman for the safety net hospitals, said the hospitals were able to justify their services and funding and demonstrate local support when Scott convened his 2011 commission.
“The public hospitals welcome more transparency,” Bartlett said.
WINNER OF THE WEEK: Beer growlers. After several years of debate, lawmakers have finally agreed to allow the sale of 64-ounce beer containers, known as growlers. Due to a quirk in state liquor laws, Florida was the only state banning the growlers, which are popular with craft beer drinkers. The growlers’ fate now rests with Gov. Rick Scott.
LOSER OF THE WEEK: Conference committees. In the eighth week of the nine-week annual session, lawmakers spend much of their time in conferences committees working out House-Senate differences on a new state budget. This year there have been no conference committees because of the chasm between the chambers over health care spending. The conference committees will meet in May if not into June as lawmakers extend their annual session well beyond the May 1 deadline to try to write a new state budget.
QUOTE OF THE WEEK: “We are prepared to stay here until June 30,” Senate President Andy Gardiner, R-Orlando, told his chamber, signaling it could take weeks if not two months to resolve a $4 billion difference in House and Senate budgets related to health care spending. The new budget year begins July 1.
