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Health officials worry Medicaid changes could jeopardize additional funding

National changes could change the way states finance supplemental Medicaid payments.

An additional $1.6 billion in Medicaid funding is expected to flow into Florida after Congress agreed to increase the amount of money the federal government spends on the safety-net program as the economy sours.

But the effects of that additional funding could be blunted if the Trump administration doesn’t halt proposed nationwide changes that affect how states finance what are known as supplemental Medicaid payments used to help provide care for poor, elderly and disabled residents.

Though the administration announced last week that it was withdrawing a proposed rule that would have changed Medicaid eligibility, the proposed changes on Medicaid supplemental payments remain.

“It’s creating a lot of anxiety and uncertainty out there,” Safety Net Hospital Alliance of Florida Chief Executive Officer Justin Senior said of the proposed changes unveiled in November. “It doesn’t matter whether you are coming from a liberal’s perspective or a conservative perspective, there are a lot of problems with it.”

Senior’s group, which represents major safety-net hospitals such as Jackson Health System in Miami, Orlando Health, UF Health Jacksonville, and UF Health Shands Hospital in Gainesville, would like the administration to withdraw the rule. He said it is at odds with efforts to make additional funding available for states as the nation responds to the coronavirus pandemic and as the need for Medicaid-funded care increases.

He’s not alone.

“It would be absolutely devastating for it to be finalized,” said Joan Alker, executive director of the Georgetown University Center for Children and Families.

Florida uses supplemental payments to increase the amount of money going toward a variety of health-care programs and services, from hospital care to long-term care to graduate medical education programs. The proposed rule deals with arcane funding mechanisms used by state governments to draw down billions of dollars in federal money, with the Trump administration saying changes are needed to increase transparency and “fiscal integrity.”

Florida Medicaid director Beth Kidder sent a letter to the federal Centers for Medicare & Medicaid Services on Jan 31 warning about a dire impact the proposed changes would have on Florida, even prior to the coronavirus pandemic.

“While we are unable to calculate the specific impact to all our state programs based on the existing ambiguities in the proposed rule, it is clear that the impact would be immediate and crippling,” Kidder wrote in a letter to Centers for Medicare & Medicaid Services Administrator Seema Verma.

But estimates from associations that represent Florida hospitals and nursing homes estimated that the impact could total more than $1.2 billion in losses to the Medicaid program.

“I think if people really understood generally what was about to happen … that people would be a little bit surprised that the administration hasn’t already withdrawn that rule, given all the stimulus they are trying to pump into the economy,” Senior said. “This looks like a very simple no-brainer.”

Medicaid is jointly funded by the state and federal governments. The federal government currently contributes about 61 cents of every health-care dollar spent. That puts Florida on the hook for the remaining 39 cents.

As part of the federal Families First Coronavirus Response Act, which was signed into law March 18 by President Donald Trump, Congress agreed to a 6.2 percentage-point increase in funding for every Medicaid program in the nation for the length of the national emergency, committing another $35 billion to help states pay for care as demand for Medicaid grows in a worsening economy.

That means the federal government will pay more than 67 cents of the Medicaid dollar in Florida.

Florida cannot disenroll any beneficiaries who were enrolled in Medicaid as of March 18 or any new enrollees in the program until after the emergency declaration has been lifted.

As of Monday night, Florida had 5,704 cases of COVID-19, the highly contagious respiratory disease caused by the coronavirus, and 71 residents had died. In all, 715 had been hospitalized, according to state data.

Nationwide, there had been 140,904 cases, with 2,405 deaths, according to the federal Centers for Disease Control and Prevention.

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Republished with permission from the News Service of Florida.

The News Service of Florida provides journalists, lobbyists, government officials and other civic leaders with comprehensive, objective information about the activities of state government year-round.

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