Pam Bondi says she’ll join Rick Scott in Medicaid lawsuit

Pam Bondi

Attorney General Pam Bondi said she will help Gov. Rick Scott sue the federal Centers for Medicaid and Medicare Services for withholding supplemental Medicaid funding for Florida’s hospitals.

In a release Bondi said her office “led the lawsuit that stopped the federal government from forcing states to expand Medicaid and we will not sit by while the Obama administration holds hostage LIP funding in an effort to force the expansion here in Florida.”

Scott’s office on Thursday issued a statement saying the federal government was “coercing” Florida into expanding Medicaid under the federal health care law by withholding supplemental Medicaid funding known as Low Income Pool. The LIP funding is meant to help offset the high costs of uncompensated care in the state.

The U.S. Supreme Court in NFIB v. Sebelius upheld by a 5-4 vote the health insurance mandates in the law that were being challenged. The justices also ruled the government could not withhold Medicaid money from states that didn’t choose to expand Medicaid under the federal law. That, they reasoned, was because the states were not given prior notice to voluntarily consent and the federal government could withhold all existing Medicaid funds for noncompliance.

The supplemental payments are made possible by a Medicaid 1115 waiver that allows the state to implement a mandatory managed care program and not to have adhered to federal law in regard to the amount, duration and scope of medical services the program provides.

The waiver was extended by the federal government last year through 2017 but the Centers for Medicare and Medicaid Services later advised the state that it would not extend the supplemental Medicaid payments beyond this summer.

The federal government reiterated its position in a letter Tuesday from Department of Health and Human Services Acting Director Vikki Wachino to Deputy Medicaid Director Justin Senior. In the letter Wachino said “coverage rather than uncompensated care pools is the best way to secure affordable access coverage to health care for low-income individuals, and uncompensated care pool funding should not pay for costs that would be covered in a Medicaid expansion.”

CMS spokesman Ben Wakana said in a news release that Florida is “free to implement Medicaid expansion or not.” The supplemental payments, Wakana said are part of a broader optional time-limited expansion demonstration project made possible by a waiver.

“(Florida) is seeking an additional optional extension which raises a different question: whether it promotes the objectives of the Medicaid statute to use demonstration authority when the state has statutory options that would better serve the low-income population,” he said.

The decision to sue the federal government comes just two weeks after Scott switched his position on Medicaid expansion. In 2013 Scott said he supported expanding Medicaid and the governor reiterated that position while campaigning for re-election last year.

Bondi said her office is working with the governor’s office to “explore our legal options to challenge the (p)resident’s gross overreach of power.”

Repeated attempts to contact the governor’s office about the lawsuit and where it would be filed have not been returned.

NFIB v. Sebelius — which former Attorney General Bill McCollum helped champion — was filed in the U.S. District Court for the Northern District of Florida in Pensacola.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.



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