Rick Scott turns to an unlikely ally for help killing Build Back Better plan

Rick Scott. Image via AP.

U.S. Sen. Rick Scott is turning to a former adversary as he continues his charge against the major spending bill President Joe Biden‘s administration is pushing.

Florida’s former Governor sent a letter to Florida hospitals asking them to provide his office with information about the amount of Medicaid supplemental payments they receive and how the potential loss of those funds could impact their ability to treat uninsured patients.

Specifically, Scott asked hospitals to provide information about Disproportionate Share Hospital payments and Low Income Pool payments — both of which are targeted for reduction in the next decade under the proposal.

“As this reckless legislation moves through Congress, it would be helpful to know how this harmful policy will affect your ability to treat uninsured patients,” Scott wrote in the Dec. 7 letter.

Scott has argued the Medicaid reductions in the Build Back Better Act target 12 states, including Florida, that have not expanded Medicaid to working, poor, childless adults under the federal health care law.

Scott is the co-founder of Columbia Hospital Corporation, which later merged with another company to become Columbia/HCA, which eventually became HCA Healthcare, the nation’s largest private for-profit health care company. He was pressured to resign from his post as chief executive after discovery that the hospital chain bilked the Medicare and Medicaid program.

This is not the first time Scott has been at odds with the White House and its policies on supplemental Medicaid funding. Scott in 2015 sued Department of Health and Human Services Secretary Kathleen Sebelius arguing the Barack Obama administration was trying to coerce Florida into expanding Medicaid, a move Scott half-heartedly endorsed in a 2014 press conference.

Scott filed the lawsuit after the Obama administration said it wouldn’t approve continued funding for what was then a $2.1 billion LIP program. Instead, the Obama administration approved a plan that authorized about $680 million in supplemental LIP payments.

Ultimately, the efforts to expand Medicaid failed and Scott dropped the suit. But the then-Governor also turned his ire to the hospital industry, which was behind the push for Medicaid expansion. Scott announced the creation of a hospital price transparency task force that traveled across the state and attempted unsuccessfully the following Legislative Session to cap what hospitals could charge.

Scott continued his focus on hospitals throughout his second term as Governor, proposing reductions in Medicaid hospital spending every year he was Governor.

But now Scott is championing Medicaid funding for hospitals. In his letter, he reminded the industry of his previous tussles with the Obama administration, which included Biden.

“Making cuts to these valued and incredibly important programs defies reason. I was opposed to these cuts when I was Governor, and I continue to oppose these cuts as your Senator,” he wrote. “I look forward to hearing from you and hope to work together to defeat this bad policy. These punitive cuts will do nothing but hurt patients and those that provide care to people most in need.”

Specifically, the Build Back Better Act proposes a 12.5% reduction in DSH payments. According to the Medicaid and CHIP Payment and Access Commission analysis of the legislation, Florida would lose $31 million annually in DSH payments.

Moreover, the proposal would reduce supplemental Medicaid funding for uncompensated care pools over the next 10 years in four states — Florida, Texas, Tennessee, and Kansas — that have not expanded Medicaid to lower income childless adults.

The Congressional Budget Office estimates the combination of reductions in DSH and LIP payments over the next 10 years will total about $34.5 billion.

“As Governor, I fought to protect Florida’s Medicaid program from the Obama administration’s shortsighted political attempt to force Medicaid expansion by cutting our (supplemental payment programs),” he wrote. “Now, as our state and nation continue to fight the COVID-19 pandemic, President Biden’s ‘Build Back Better’ is reviving the Obama-era playbook and proposing significant cuts to Florida.”

Safety Net Hospital Alliance of Florida Chief Executive Officer, Justin Senior, told Florida Politics Wednesday his association appreciates Scott’s support.

“The cuts aren’t warranted, and we definitely appreciate his speaking out on the issue,” said Senior, who served as secretary of the Agency for Health Care Administration for part of Scott’s eight-year tenure as Governor.