The federal government on Tuesday sent a letter to Deputy Medicaid Director Justin Senior saying that expanding Medicaid to low-income, uninsured Floridians is a better use of tax dollars than establishing Medicaid supplemental spending formulas such as the Low Income Pool.
Department of Health and Human Services Acting Director Vikki Wachino said in the April 14 letter that “coverage rather than uncompensated care pools is the best way to secure affordable access coverage to health care for low-income individuals, and uncompensated care pool funding should not pay for costs that would be covered in a Medicaid expansion.”
Wachino also notes in her letter that Medicaid payments should support services that are provided to Medicaid beneficiaries” and “provider payment rates must be sufficient to promote provider participation and access, and should support plans in managing and coordinating care.”
Additionally, Wachino notes that the transition periods can “ease the process of reducing the LIP as the state makes the transition to broader Medicaid coverage for its residents as sustainable rates” and that a disproportionate share of hospital payments will remain available to support uncompensated care.
“I look forward to continuing our discussions on how to best support the health needs of low-income Floridians and Florida’s healthcare system while at the same time spending federal tax dollars most wisely and meeting the objectives of the Medicaid program and the Affordable Care Act.”
The letter comes as the Florida Legislature tries to bring the 2015 session to an end on time. The House and Senate have been unable to agree on a spending plan the upcoming fiscal year. The Senate proposes using $2 billion Low Income Pool funding and more than $3 billion in federal funding for Medicaid expansion while the House budget doesn’t contain either.
The news of the letter spread quickly through the Capitol.
House Speaker Steve Crisafulli in a statement said it was “unthinkable” that the federal government would leave the state on the hook for more than $1 billion “simply because they want a specific policy outcome.”
Medicaid expansion would not cover all Floridians, Crisafulli said, adding that LIP still would be required.
“We have long warned Floridians that the federal government is capable of holding states hostage based on untenable strings attached to federal funding, he said. “Nothing should give our state more pause than what has occurred today.”
Meanwhile, House Democrats saw the letter differently.
“In essence CMS is saying they are willing to dance. I think we should,” said House Minority Leader Mark Pafford.
