Bob SparksWhat a week. First, Gov. Rick Scott and Attorney General Pam Bondi announced Florida is suing the Obama administration over the Medicaid expansion issue. Then, we witnessed some remarkable political gamesmanship when the House adjourned three days early.
The words “insurmountable differences” on the budget and Medicaid expansion accompanied the banging gavel in the House chamber. No celebratory dropping of hankies for sine die this year. Those are now replaced with a few boxes of facial tissues for those mourning the death of several bills seemingly on track for passage.
What will happen to those bills involving Speaker Steve Crisafulli’s top priority of water policy, or film incentives, fracking, Uber and Scott’s tax-cut package? Will any be added to the call for special session?
Last week Scott was said to be “persuading” senators to support his tax cuts. Insiders said the message was “pass the tax cuts” or face vetoes of some favored Senate bills. In the end, the Senate wasn’t the real barrier.
“I realize we just killed a tax bill that gave $690 million back to Florida’s families and businesses,” Crisafulli told the news media afterward. “But at the end of the day, we did what we felt was right.”
Most media coverage, as well as this space, argued that some low-income people truly needed some help with insurance coverage. The Senate plan was created on conservative principles and had an “out” clause if the federal government did not hold up its end of the bargain.
What’s more, everyone understood federal dollars for hospitals from the Low Income Pool (LIP) program would be jeopardized if Florida did not expand Medicaid. Crisafulli addressed this and the perils of expansion while making the case for the House in an op-ed piece.
“In fact, if we choose Obamacare expansion, 600,000 will lose eligibility for their subsidies, of which 257,000 would be forced into Medicaid,” he wrote. The state was “told that continued LIP funding is linked to Medicaid expansion.”
Crisafulli, the Senate and Scott had every reason to believe that was the case. The word came directly from the Obama administration.
“We articulated to the state that we believe the future of LIP, sufficient provider rates, and Medicaid expansion are all linked in considering a solution for Florida,” said Ben Wakana, a spokesman for the U.S. Department of Health and Human Services. Wakana made this statement about two weeks ago.
Just hours after the Scott/Bondi lawsuit was filed, a new message came from the Obama administration.
“The decision to expand Medicaid, or not, is a state decision,” said Aaron Albright, a spokesman for the federal Centers for Medicare and Medicaid Services (CMS).
The Palm Beach Post’s John Kennedy reports Albright also said LIP funding is not hinged on expanding Medicaid.
This would appear to open the door for agreement on structural changes, still a demand of the Obama administration, to LIP. Plugging a potential $1.3 billion budget hole would lead to more focused budget and policy talks.
Now the administration says they have not changed positions, basically claiming a reform of the LIP program can keep Florida’s program going without Medicaid expansion. There is some truth to that, but there is also more to the story.
During last week’s closed-door session among Republicans, Crisafulli promised the Obama administration “will eventually relent” in their pressure tactics involving LIP. He reacted quickly to the CMS statement by applauding the administration for its new position and stating the House “stands ready” to begin budget negotiations in a special session.
The Senate has a slightly different take. President Andy Gardiner and his chamber are still operating under the assumption changes must be made to LIP or funding will not continue at current levels. A budget hole would still remain.
The point to the reforms, still required by the feds whether or not Florida expands Medicaid, is to move certain items out of LIP that should be covered via expansion. According to Senate Deputy Chief of Staff Katie Betta, the Senate is now evaluating how much Florida could receive if the Legislature fails to come to an agreement.
It is difficult to see how people or hospitals will not be adversely affected without Medicaid expansion. The federal government still appears to hold a great deal of leverage.
The spectacle we are witnessing is usually the result of partisan differences. Not this time. The damage inflicted on the Republican brand is clear evidence the positions of both sides are based on principle. Equally important is the apparent total breakdown of the relationship between Gardiner and Crisafulli.
Leaders should call for the special session and add some of the worthy bills to the call. Their staffs should be working on face-saving compromises while their spokespeople work on face-saving statements to explain the compromises. Statements would include “lending a temporary hand to those in need” and “accountability” in the same paragraph.
Then, for goodness sake, drop the hanky.
Bob Sparks is a business and political consultant based in Tallahassee. Column courtesy of Context Florida.
