Former Jeb Bush health care czar says he’d expand Medicaid coverage

in 2017/Statewide/Top Headlines by

Jeb Bush‘s former health care czar said Florida should take the Medicaid expansion dollars to provide health care access to the poor.

However, in a FaceBook post former Agency for Health Care Administration Secretary Alan Levine also said he thought the federal government was “overplaying its hand in Florida” by threatening to end the supplemental Medicaid funding known as Low Income Pool, or LIP, if the state doesn’t expand Medicaid as envisioned in the federal health care law.

He also said the move “forever changes the dynamics” between the the Centers for Medicare and Medicaid’s relationship and the states.

“Using such an important program, like Low Income Pool, as a political lever, is unusual and bad policy,” Levine wrote in his post.

Now the president and chief executive officer of Mountain States Health Alliance in Tennessee, Levine was the architect of the five-county Medicaid managed care pilot project that Bush championed in 2004. Levine helped Bush secure the 1115 waiver needed to launch the program as well as the Low Income Pool program.

Levine, who in addition to working with Bush worked for Louisiana Gov. Bobby Jindal, said the move underscores conservatives’ argument that the federal government won’t keep its promise to provide ongoing federal match to states that expand Medicaid coverage. He also said ending the LIP program for political reasons gives Republicans “a case in point example” of how the federal government can’t be trusted to keep its word.

The Centers for Medicare and Medicaid Services on Tuesday sent Deputy Secretary for Medicaid Justin Senior a letter advising him that the federal government thinks that providing access to health care is a better use of taxpayers’ money than uncompensated care pool such as LIP. The letter also advised Senior that LIP is linked to Medicaid expansion.

Senior responded to the federal government on Wednesday with his own letter. He advised CMS officials that in the challenge to the federal health care law, the U.S. Supreme Court ruled the federal government could not coerce states into expanding Medicaid under the federal health care law by withholding Medicaid funding from states that refused to expand coverage.

With no agreement between the state and federal government in sight,  legislative leaders on Wednesday acknowledged that the 2015 session won’t end on time because the House and Senate won’t be able to reach accord on  proposed spending plans for the upcoming fiscal year. The chambers are more than $4 billion apart because of their difference on health care spending. The Senate budget contains federal funding to expand Medicaid as well as continuing LIP dollars while the House budget contains neither.

“The next two weeks will tell the rest of the story,” Levine wrote in his post. “As I said, maybe it will work, but it forever changes the dynamic between CMS and the states, and my friends on the left certainly won’t like it when they are on the receiving end of such tactics by a different administration.

“That said … I understand the frustration by those who want to see more coverage, and the inability to reach agreement leads to tactics like this.”