Future amount of ‘LIP’ money unclear

A top state Medicaid official said she wasn’t sure how much spending authority the federal government will approve.

One of the most-important parts of a Medicaid “waiver” that Florida has received from the federal government is the authority to receive up to $1.5 billion a year in supplemental money to help care for poor, elderly and disabled people.

But a top state Medicaid official said Monday she wasn’t sure how much spending authority the federal government will approve for the so-called Low Income Pool program as part of a state request to extend the Medicaid waiver.

“It is possible that it could change,” Medicaid director Beth Kidder said Monday during a meeting on the state’s request for a two-year extension, which was submitted last week. “But we don’t have any indication one way or the other.”

The federal government requires the state to hold public hearings and collect public testimony on the proposed extension of the waiver, which involves seeking approval to waive rules that would normally apply in the Medicaid program.

The Low Income Pool, or LIP, has been approved by the federal government to help offset the costs of uncompensated care related to Medicaid patients and people who are underinsured or uninsured.

Initially approved by former President George W. Bush’s administration, Florida’s LIP spending authority totaled $2.1 billion at its highest point. But after the state refused to expand Medicaid as part of the Affordable Care Act, the Obama administration significantly reduced LIP authority.

In fiscal year 2016-20717, Florida received $608 million in supplemental funds. After President Donald Trump was elected in 2016, the federal Centers for Medicare and Medicaid Services said Florida could spend up to $1.5 billion annually in LIP

But Florida has been unable to tap that entire amount. For instance, in fiscal year 2017-2018 Florida received $757 million in LIP funds. The amount totaled $858 million in fiscal year 2018-2019 and $954 million in fiscal year 2019-2020.

The continuation of the LIP Program is one reason Florida is asking the federal government to extend the waiver. Though the waiver allows the state to operate a mandatory Medicaid managed-care program, Florida could also accomplish that through its Medicaid state plan.

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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