Scott rules out Medicaid expansion

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TALLAHASSEE

Florida Gov. Rick Scott addresses a joint session of the Florida Legislature, Tuesday during his State of the State address.  (AP Photo/Tampa Bay Times, Scott Keeler)

Florida Gov. Rick Scott addresses a joint session of the Florida Legislature earlier this year during his State of the State address. (AP Photo/Tampa Bay Times, Scott Keeler)

With the 2015 legislative session in shambles and a government shutdown looming, Gov. Rick Scott on Tuesday stepped up his opposition to the Senate plan to expand Medicaid to cover 800,000 low-income Floridians.

 

“It’s not going to happen,” Scott said. “There is no support in the House. I’m not going to support it. It’s not a program that has worked.”

The annual legislative session ended Friday night, with no budget agreement and after the House walked away three days earlier – in move that violated the state constitution. The impasse was the result of a $4 billion difference in the legislative budget bills and the House’s adamant opposition to the Senate’s plan to offer private insurance through a Medicaid expansion.

Scott said he is studying all his options, including calling lawmakers back into a special session to pass a bare-bones budget to keep the state operating when the new budget year begins on July 1. The Senate has proposed a June 1-20 special session that would include consideration of a new state budget and Medicaid expansion, although the House has not agreed to the agenda.

“It’s one of the things I’m looking at,” Scott said about calling back lawmakers himself. “We’ve got to get a budget done by the end of June. I’m going to make sure we continue to run the state. So I’ll do what the right thing is for our citizens.”

Scott’s comments in opposition to the Senate’s Florida Health Insurance Affordability Exchange Program (FHIX) are the strongest yet since he reversed his position earlier this spring and came out against Medicaid expansion under the Affordable Care Act.

Critics say Scott bears responsibility for the impasse because of the mixed messages he has sent: opposing Medicaid expansion after the Affordable Care Act was approved, then favoring the expansion in 2013, then reversing himself.

Now, Scott’s clear alignment with the House position could complicate finding a compromise with the Senate on the health care funding impasse.

The Senate had advanced its exchange program plan as way to provide insurance to more low-income Floridians, anticipating the demise or reduction of the $2.2 billion federal program, known as the low-income pool (LIP), that compensates Florida hospitals for their care of the uninsured.

A spokeswoman for Senate President Andy Gardiner, R-Orlando, said the Senate remains “committed to advancing long-term solutions to address health care coverage for low-income Floridians.”

“The Senate advanced FHIX as a free-market, consumer-driven solution with conservative guard rails to protect Florida taxpayers if the federal government fails to meet its commitments,” Katie Betta said.

“The president (Gardiner) is open to other ideas for long-term solutions to address health care coverage for low-income Floridians. Currently, the Senate’s FHIX proposal is the only option on the table,” she added.

Scott, whose administration formally asked for an extension of LIP in late April, has become embroiled in a lawsuit with the U.S. Department of Health and Human Services (HHS) over LIP and its linkage to Medicaid expansion.

Scott, along with Attorney General Pam Bondi, has filed a lawsuit alleging the federal government is violating a U.S. Supreme Court ruling that states could not be “coerced” into expanding Medicaid. Texas and Kansas, which have not expanded Medicaid and have similar hospital funding programs, are supporting Florida’s lawsuit.

Scott opened his meeting with the Cabinet on Tuesday by praising Bondi for her role in the lawsuit and saying it was “wrong” for the federal government “to try to force us to expand Obamacare.”

“You cannot coerce a state into expanding Medicaid,” Bondi said. “That’s an issue, Medicaid expansion, that needs to be decided by our lawmakers not by the federal government. The Supreme Court has spoken loud and clear on that issue.”

Yet with the lawsuit against HHS as a backdrop, Scott is traveling to Washington, D.C., to meet with the head of that federal agency, Sylvia Burwell, today to request her agency continue to fund Florida’s $2.2 billion LIP program.

Scott said he had no qualms about the lawsuit and the state’s advocacy for continuing the hospital funding program.

“They shouldn’t be doing what they’re doing,” Scott said. “What they’re doing is illegal.”

In a related action, Scott issued an executive order on Tuesday creating a Commission on Healthcare and Hospital Funding, which he said could help guide his office and lawmakers as they deal with the health care funding issues and the new state budget.

The commission, which will be appointed by Scott, will look at “the role of taxpayer funding for hospitals, insurers and health care providers.” It will also look at the affordability, access and quality of health care services that is supported by public funding.

Scott, a former private hospital executive who has been skeptical about the role of public hospitals, said the commission would also look at how much “taxpayer-funded hospitals” pay for lobbyists, campaign contributions and advertising.

The governor’s order did not specify the size of the commission or give any indication of its timetable. Scott created a similar commission in 2011 that concluded that public hospitals have a role in Florida’s health care system.

The head of the Safety Net Hospital Alliance of Florida, which represents the hospitals that provide of the bulk of uncompensated care to low-income Floridians, said the hospitals would work with the new commission.

“Florida’s safety net hospitals are transparent and accountable and look forward to sharing with the commission how they achieve operational efficiencies while providing high-quality healthcare to all patients seeking treatment, regardless of their ability to pay,” said Tony Carvalho, president of the hospital group.

Carvalho said the group hopes to have some of its members on Scott’s commission and he said the group would continue to advocate for financial support for the hospitals that have large caseloads of uncompensated care.

“We encourage Gov. Scott to advocate for Florida's fair share of supplemental healthcare funding in the LIP replacement model to maintain current levels of support for our state’s healthcare safety net services and programs,” Carvalho said.

EARLIER: With the 2015 legislative session in shambles and a government shutdown looming, Gov. Rick Scott Tuesday stepped up his opposition to the Senate plan to expand Medicaid to cover 800,000 low-income Floridians.

“It’s not going to happen,” Scott said. “There is no support in the House. I’m not going to support it. It’s not a program that has worked.”

The 2015 Legislature ended Friday night, with no budget agreement and after the House walked away three days earlier in move that violated the state constitution. The impasse was the result of a $4 billion difference in the legislative budget bills and the House’s adamant opposition to the Senate’s plan to offer private insurance through a Medicaid expansion.

Scott said he is studying all his options, including calling lawmakers back into a special session to pass a bare-bones budget to keep the state operating when the new budget year begins on July 1.

Check back later  for more on this developing story.

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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 5, 2015
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