Senate counters House with Medicaid expansion; other health care items may be in play

healthcare-money

The Florida Senate has not backed off its position that working uninsured Floridians need to have access to health insurance and that the Medicaid supplemental program known as Low Income Pool should remain intact.

In a counteroffer to the House’s offer to put $200 million into health care financing the Senate held firm on its Medicaid expansion and put $604.8 million in contingencies to offset LIP losses and to shore up Medicaid HMOs that are at risk because of increased pharmaceutical costs.

It also offered to plow $263.8 million that would be generated from implementing the FHIX plan into public education funding.

Additionally, the Senate counteroffer makes clear that the chamber will seek guidance from the Centers for Medicare and Medicaid Services in regard to LIP funding as well as the potential approval of the Florida Health Insurance Exchange program, commonly called FHIX.

The Senate made its counteroffer as it ended session Friday. Like the House the night before, the offer was made in a very public way, before the press and the full chamber. It’s unusual for “allocations” to be publicly negotiated, but it has been an unusual session.

Meanwhile, there will be more than health care financing that will be discussed as the chambers try to resolve health care funding.

Senate Appropriations Committee Chairman Tom Lee said he has heard “a lot of conversation, a lot of background chatter about certificates of need (CON), medical surgical centers selling insurance across state lines, major changes to scope of practice, things of that nature, that would need to go along with some dramatic reforms.”

Those issues have been important to the House which wants to “disrupt the status quo” when it comes to health care delivery and financing. At its final regularly scheduled meeting of the 2015 session House Health and Human Services Committee Chairman Jason Brodeur told his committee that CONs, health care mandates and medical malpractice changes would be front and center during the 2016 session.

The House did not propose CON reforms this session but the chamber has championed a bill, HB 999, that would allow ambulatory surgical centers to care for patients for up to 24 hours. The bill also creates a new licensing category for “recovery care centers” where stable patients can stay for up to 72 hours. Recovery care centers would not be part of a hospital and would be in direct competition with hospitals.

Senate President Andy Gardiner thanked House Speaker Steve Crisafulli and Gov. Rick Scott for the Thursday night offer to provide $200 million, given the previous opposition they have shown to “backfilling” the loss of federal Low Income Pool funding with general revenue.

Gardner, meanwhile, told his members to go home this weekend and advised them that the Senate won’t go into session until 1 p.m. Monday. Gardiner reiterated the position that the Senate is prepared to remain in an extended session until June 30. An extended session would prevent members from being able to raise campaign money.

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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