Christine Jordan SextonThe Senate Health Policy Committee on Tuesday delayed Department of Health Secretary John Armstrong‘s confirmation after he refused to answer Medicaid questions. Panel members asked him whether expanding Medicaid would improve Floridians’ health care outcomes or whether he supported the Senate’s alternative proposal to expand Medicaid.
Sen. Aaron Bean asked Armstrong to return soon and said the committee looked forward to continuing the hearing “very soon.”
Initially, Sen. Don Gaetz asked Armstrong about his position on the Oregon Medicaid Health insurance experiment that used a lottery system to pick who would be eligible for a Medicaid expansion and who wouldn’t. Two years after the Lottery experiment researchers found that Medicaid had no statistically significant effect on physical health measures, though it did increase use of health care services, raised rates of diabetes detection and management, reduced rates of depression, and reduced financial strain.
Gaetz tried twice to get Armstrong to answer questions about the Senate FHIX plan and whether he supported the plan. Armstrong both times avoided directly answering the question.
Sen. Arthenia Joyner, who had pressed Armstrong earlier in the confirmation process about infant mortality rates among black people, then asked whether the governor’s office had told him not to answer questions. “I am under no constraints,” Armstrong said.
When she pressed him for an opinion on whether the Senate plan would improve care, Armstrong replied, “I have not formulated an opinion. My focus remains on the principle determinants of health which remain the behavioral, and the social and environmental, and that is where a lot of tough work remains. There is not a quick solution to retool the environment so that healthy choices become the easier choices.”
After Armstrong’s reply, Sen. Bill Galvano moved that the confirmation be temporarily deferred.
“Hopefully, with temporarily postponing this confirmation it will give the surgeon general time to reflect and be able to give us an answer on what the DOH’s position is on our health exchange and our approach to the Low Income Pool,” Galvano said.
Armstrong immediately left the committee room and agreed to take one question from a reporter. When asked whether he his refusal to comment on Medicaid expansion was the reason the committee deferred action, Armstrong said he’s “committed to the health of nearly 20 million Floridians and 2 million visitors on any given day.”
Armstrong’s refusal to answer whether he supports or opposes a Medicaid expansion follows the lead set by his boss, Gov. Rick Scott, who released a statement Monday after he refused to answer reporters’ questions on whether he supports a Medicaid expansion or supports the Senate’s alternative approach. The Senate idea would use traditional Medicaid money available under the federal health care reform, often referred to as Obamacare.
Scott’s statement Monday said, “It would be hard to understand how the state could take on even more federal programs that (the federal government) could scale back or walk away from.”
After funding the Low Income Pool — supplemental Medicaid funding that has helps pay the costs of the under-insured and uninsured for nine years — the Centers for Medicare and Medicaid Services advised Florida in April 2014 that it would not continue to fund the LIP beyond this summer.
The Low Income Pool and Medicaid expansion have threatened to throw the 2015 regular Legislative Session into overtime. The Senate has included a Medicaid expansion as well as LIP dollars in its proposed spending plan for the 2015-16 fiscal year. The House has neither in its budget. As a result the two chamber are more than $4 billion apart in their spending proposals. Additionally, the Senate has refused to pass tax cuts without having a resolution on the LIP dollars while the House has passed $690 million in tax cuts.
