Christine Jordan Sexton
As Medicaid expansion and health care access threaten to blow the 2015 Legislative Session sky high, Gov. Rick Scott has remained quiet on where he stands.
Plus there are no signs so far that will change even though the ongoing stalemate over the budget could derail some of his top priorities for this year’s session.
Scott’s press office didn’t comment on whether Scott supports a Medicaid expansion under the federal health care law or a modified Medicaid expansion as proposed by the Florida Senate.
Spokesman John Tupps on Friday said Scott was out of town and that he couldn’t comment on whether the governor still supports expansion or the Senate’s modified plan.
Scott’s record regarding Obamacare is well known: He initially opposed President Barack Obama‘s overhaul and financed an anti-Obamacare ad campaign under the moniker Conservatives for Patients Rights.
Then in 2013 — with poll numbers showing him vulnerable for re-election — Scott did what some thought was unimaginable: He announced that he supported expanding Medicaid for low income Floridians so long as the federal government picked up the entire tab. He made the announcement but never lobbied for its passage.
On the gubernatorial stump in 2014 Scott reaffirmed in an interview with the Miami Herald/Tampa Bay Times that he supported the expansion so long as the federal government pays for it.
Medicaid expansion under the Affordable Care Act is funded completely by the federal government through 2016.
Now after Scott has won a second term — and reportedly is interested in seeking a U.S. Senate seat in 2018 — he has remained quiet on the main issue that threatens to fracture this year’s Session. At the same time his administration has come under fire for supposedly making “misstatements” about ongoing negotiations with the federal government that could affect what happens during the final month of the session.
Medicaid, and the supplemental Medicaid program known as Low Income Pool, have dominated much of the discussion of the 2015 regular legislative session, now past its midway point.
LIP is a pot of mostly federal and county money that is used to help supplement hospitals for providing uncompensated care. The $2 billion program expires this summer and Florida is trying to negotiate to keep the program intact.
The House and Senate are more than $4 billion apart in their spending plans because of LIP and Medicaid expansion.
Agency for Health Care Administration director Liz Dudek told senators last week she was “actively negotiating with the federal government,” and that she was looking toward the next meeting with the Centers for Medicaid and Medicare Services.
Just one day later Dudek issued a statement that the federal government had discontinued its talks with Florida because Eliot Fishman, a leading official at the Centers for Medicare and Medicaid Services, was out of town for two weeks. She said the news was sudden and disappointing.
The news of broken negotiations spread through Tallahassee quickly and caught many in the Capitol — and even those at the Centers for Medicare and Medicaid Services in Baltimore — off guard.
The statement was sent out after U.S. Sen. Bill Nelson and U.S. Rep. Debbie Wasserman Schultz visited Tallahassee on Wednesday and delivered the message that LIP would not be extended without a Medicaid expansion.
It also followed news that two state senators — Rene Garcia and Garret Richter — traveled to Baltimore to meet with CMS officials. There they discussed a modified LIP formula the Senate had created in hope of keeping the supplemental Medicaid dollars flowing into the state.
Dudek’s statement also caught Senate President Andy Gardiner off-guard. Gardner said Garcia and Richter had reported that the “the dialogue was pretty good.”
The Centers for Medicare and Medicaid Services also was surprised by AHCA’s release and, when pressed by reporters, issued its own statement the next day clarifying that although Fishman wasn’t available it did not cut off negotiations with the state.
CMS said that the agency shares Florida’s concerns of “securing access to high quality health care coverage for low income Floridians.”
AHCA issued a second release, though, confirming that while CMS may be open to further negotiations, the agency was not.
“At this time, no date has been set for a future meeting.”
The statements from AHCA drew criticism from a Nelson spokesman.
“Misstatements aren’t helpful toward achieving the goal of a positive outcome,” Dan McLaughlin told the Associated Press.
House leaders, meanwhile, have ratcheted up their criticism of the Senate proposal. Senate leaders have warned that other spending priorities — such as tax cuts being sought by Scott — will be hard to pass if hospitals are confronted with large spending cuts.
The governor, however, could change the balance if he were to come out in opposition to Medicaid expansion, even though to do so could threaten his own legislative agenda.
