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Rick Scott healthcare agenda: A no-LIP budget and nixing certificates of need

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Gov. Rick Scott unveiled what appears to be an ambitious healthcare agenda he plans on tackling in the weeks before July 1.

Though the governor didn’t have a healthcare agenda going into the 2015 session, Scott announced in a press release that he will develop a Commission on Healthcare and Hospital Funding that will, among other things, examine eliminating Florida’s certificate of need laws. Certificate of need is a regulatory program to curb the growth in heatlhcare expenditures by limiting the proliferation of high-cost services and goods.

He also wants to begin working on an interim budget for the 2015-16 year that contains no Low Income Pool funding or any additional federal Medicaid dollars for expansion of health care to 800,000 low-income working Floridians who would qualify for Medicaid under the federal healthcare law.

Scott said deleting the CON laws would increase competition among healthcare providers, lower hopsitals costs and therefore lower hopsitals’ need for federal dollars, which “is a win win for Florida taxpayers.” Scott said that decreasing costs is the best way of increasing access to health care.

The release also hints at the notion that there are other alternatives to increase access to health care other than expanding Medicaid under the federal healthcare law, often referred to as Obamacare.

“(T)here are other ideas we could begin to explore to increase access to health care, including having the federal government give the state a 100 perent fedeally funded block grant to develop a flexible program that meets the unique needs of Florida’s population.”

Scott has been releasing information about the commission over the past several days but the latest release still does not mention who will serve on the commission or when the commission will begin meeting, though the governor notes it will have to begin its work “in the weeks ahead and gather information that could inform the building of a budget before July 1.”

Healthcare financing–the contiunation of the Low Income Pool program and Medicaid expansion–were the driving forces behind the 2015 legislative session falling apart. The one must-pass bill of the year–the General Appropriations Act–didn’t get crafted because the House and Senate couldn’t overcome a more than $4 billion difference in their proposed spending plans.

The difference is attributable to the fact that the Senate budget included money for Medicaid expansion as envisioned under Obamacare, as well as $2 billion in Low Income Pool funding, whereas the Hosue budget contained neither. LIP is a supplemental pot of Medicaid dollars made possible by the 1115 waiver that allows Florida to operate a statewide mandatory Medicaid managed-care program. Florida has submitted a proposed amendment to its 1115 waiver and the Agency for Health Care Administration currently is seeking public testimony on the waiver amendment. 

Scott said in the release that it’s his hope that the Obama administration will approve Florida’s amendment to extend the Low Income Pool program.

“However, we should begin preparing a budget in the interim that could be taken up in a special session without any LIP funding and without any expansion of Obamacare. I look forward to continuing to work with Senate and House leaders in the weeks ahead to address critical funding needs and identify when and how we can direct over $1 billion in surplus state tax revenue back to the Florida citizens who earned it. After all, this is their money – not government’s.”

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