Gov. Rick Scott said today that if the state and the federal government can’t come to an agreement on Florida’s Low Income Pool (LIP) program, he won’t supplement the program with state funds.
“Florida taxpayers fund our federal government and deserve to get a return on their investment,” Scott wrote in a letter to President Obama. “Moreover, we have worked hard to turn Florida’s economy around and cannot afford to fund programs started by the federal government.”
The $2 billion program LIP program, which reimburses hospitals that treat large numbers of poor and uninsured patients, is scheduled to expire on June 30. The state Agency for Health Care Administration is hoping to reach a deal with the federal government to keep the federal portion of the funding in place.
But Tampa-area U.S. Rep. Kathy Castor says that certainly won’t happen before the end of the legislative session in May.
“They’re just in the initial stages of conversation,” said the Tampa congresswoman, who said she briefly chatted today about the issue with U.S. Health and Human Services Secretary Sylvia Burwell at the Supreme Court. Castor said that a report produced by the U.S. Centers for Medicare & Medicaid Services, or CMS, says that the Florida Low Income Pool is outdated and in need of reform, “and we just don’t know at this point what this means monetarily.”
She added that CMS is also looking for hard data to ensure that if they partner with Florida in primary care that it’s proven to be effective, and that those funds “aren’t just going into a black hole of private managed care.”
Since 2005, Florida has had a Section 1115 Medicaid waiver establishing a low-income funding pool to aid the state’s hospitals. The state has received between $1 billion and $2 billion annually to support safety net providers. But that’s at risk now with the feds saying they don’t intend to continue that waiver.
There has been speculation that the Obama administration would once again find a way to fund the Low Income Pool program if the state were to go ahead and agree to Medicaid expansion, which would provide health-care insurance for roughly a million people in the state. Such a move is backed by a number of business groups in the state and even Florida Senate President Andy Gardiner, but the House remains obstinate and Scott has done nothing to push them.
“Isn’t that inconsistent?” asked Castor on a conference call with Florida-based reporters on Wednesday afternoon. She said that Scott and other Republicans are demanding federal dollars to help with health care, yet conversely they refuse to accept the federal plan on expanding Medicaid, where the feds would pick up all of the costs for the first three years and 90 percent after that. “They need to be more consistent, more logical, and put the care of their neighbors and the health of our state ahead of those old ideological battles,” she said.
Castor was selected by House Minority Leader Nancy Pelosi to attend the oral arguments in the U.S. Supreme Court today on the closely scrutinized King vs. Burwell case, in part because of her experience with drafting the Affordable Care Act and Florida’s position in leading the nation for the number of ACA sign-ups. The case asserts that the law forbids the federal government from providing tax subsidies for insurance purchases in the three dozen states (such as Florida) that have not established their own insurance marketplaces.
The White House has been criticized for not offering up a “Plan B,” to deal with the millions of people currently on the Affordable Care Act who would lose their subsidies and ultimately their coverage if the court rules for the plaintiffs.
Castor said theoretically Congress could respond to that, but the fact that the House of Representatives has voted nearly 60 times to repeal it indicates that is not a viable solution.
Another option would be for Florida to create its own exchange for people to purchase health insurance. But as somebody who was there for the drafting and discussions of the ACA, Castor said there was never any discussion that subsidies wouldn’t be provided for in a state that relied on the federal and not a state exchange.