Christine Jordan Sexton
The federal government has temporarily cut off Low Income Pool negotiations with Florida, making it difficult for the Legislature to complete its budget and bring the regular legislative session to an end on time.
Agency for Health Care Administration Secretary Liz Dudek sent a statement to the press late Wednesday announcing that the chief negotiator for the Centers for Medicare and Medicaid Services, Eliot Fishman, will not be available for at least two weeks.
“This was sudden and disappointing news,” Dudek said in the release, adding that, to date, negotiations had been productive and positive. “For CMS to discontinue LIP negotiations now is troubling and could signal the abrupt end of this federal health care program in Florida.”
Senate President Andy Gardiner conceded that the delay makes completing a budget on time “somewhat of a challenge, but anything is possible. But we’ll see.”
Deputy Secretary for Medicaid, Justin Senior, told Florida Politics last month that he was optimistic the state would have a broad agreement with CMS over the LIP program and how much money Florida could expect by the second week of April. That way, Senior said, the Legislature could use the dollar figure to help craft the budget and adjourn on time.
The Centers for Medicare and Medicaid Services told Florida in April 2014 that it would not extend the Low Income Pool program beyond the summer. Nevertheless, Gov. Rick Scott included the $2 billion in his proposed budget for the upcoming year.
LIP provides supplemental Medicaid funding to the state which directs it mostly to hospitals, but also federally qualified health centers, graduate medical education and HMOs. Counties contribute the majority of money Florida uses to draw down federal funds, but there also is a smattering of state money targeted to LIP.
House Speaker Steve Crisafulli said in a prepared statement that the federal government was using LIP funding to “bully” the state into expanding Medicaid to low income, uninsured residents. The federal health care law extends Medicaid eligibility to Americans living at or below 138 percent of the federal poverty level.
“LIP and Medicaid expansion are separate issues,” Crisafulli said in a statement. “Florida stands ready today to create a new model for LIP, but we will not be bullied into expanding a broken Medicaid program.”
Crisafulli said the House believes the current Medicaid system is broken and Obamacare is tremendously flawed. “Florida needs more flexibility from Washington to deal with our uninsured population.”
The Florida House has proposed a $76.1 billion budget and the Senate an $80 billion budget. The difference is because of the Senate’s inclusion of money for a Medicaid expansion as well as the continuation of LIP dollars. The House’s budget doesn’t include the federal match for LIP dollars or the federal dollars available for Medicaid expansion. The House budget does, however, contain the county funding that the state uses to draw down the federal matching LIP dollars.
“This is a potential game changer,” said Jan Gorrie, healthcare lobbyist and managing partner with the lobbying firm Ballard Partners.
