Life and politics from the Sunshine State's best city

First public meeting in Orlando on Medicaid waiver draws small crowd

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Supplemental Medicaid funding and whether Florida should expand healthcare access to 800,000 uninsured working Floridians was the issue that brought the 2015 session to a grinding halt.

In Orlando, though, the issue of Low Income Pool funding and Medicaid expansion didn’t draw crowds as the Agency for Health Care Administration held the first of three public meetings on a proposed amendment to the 1115 waiver that allows the LIP program to operate.

Though scheduled to last for two hours, just a handful of people spoke.  Deputy Secretary for Medicaid Justin Senior spoke for nearly half the meeting–which lasted slightly more than one hour– presenting the proposed amendment to extend the Low Income Pool.

Most of those who presented at the meeting were affiliated with the healthcare industry, either with a hospital, medical society, federally qualified health center or even with graduate medical education.

All the comments were in support of maintaining the Low Income Pool, the supplemental funding made available under a Medicaid 1115 waiver that allows Florida to operte a statewide mandatory managed-care program.

Nemours Children’s Hospital Managing Director of Strategy and Business Development Vonda Sexton testified that  if the LIP program were to be eliminated the facility, which provides $111 million in uncompensated health care, would  have to cut $10 million from its budget.  The hospital isn’t looking “for a handout” but more than half of the families they serve have insurance through Medicaid, which does not cover the costs of care. “It only works because the LIP program provides supplemental payments which reduces but does not eliminate the financial shortfall of Medicaid.”

Executive Vice President of the Duval County Medical Society Bryan Campbell testified that the LIP program is vital to the continuation of UF Health Jacksonville and that the hospital–which receives $95 million in supplemental LIP payments–could be forced to close within six months if LIP were not renewed. Campbell said that UF Health Jacksonville is the only level 1 trauma center in Northeast Florida.

Unlike Sexton, who kept her remarks specifically to LIP, Campbell said that LIP is a “tempoary solution” and that the funds by themselves are not adequate and that Florida AHCA must also submit an expansion plan for the federal government to consider in addition to LIP.

Florida Senate President Andy Gardiner has asked AHCA to submit the Medicaid expansion plan, called FHIX, to the Centers for Medicare and Medicaid Services for consideation along with the proposed amendment for the LIP program.

Before AHCA can submit the proposed amendment, it must first take public testimony. Senior said the state is required to hold two meetings but that the agency was holding a third.

While most of those who testified were affiliated with healthcare providers, Maria McCorkle — mother of two children, Anna and Connor — was a benefactor of the LIP fundings. She said that if LIP were eliminated it wouldn’t be disruption for her family, it would be devastation.

McCorkle said the children are patients at Nemours and that before going to the clinic no one could tell her what was wrong with her son or whether he would live to be a teenager.  She said it was a “devastating diagnosis without a diagnosis.”

Nemours was able to diagnose a rare dormant muscular dystrophy that the children had inherited from her. Hospitals  like Nemours have given my family hope, they have given my family answers, they have given my children a future.”

She said critically ill children in central Florida need a hospital like Nemours. “Please remember that my children, it’s not their fault, they are sick. They are not a burden. They are not political pawns, but they are the future of this great state and this great country.”

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