Florida Gov. Rick Scott said on Thursday he will sue federal government for “coercing” the state into expanding Medicaid under the federal health care law by withholding supplemental Medicaid funding known as Low Income Pool.
“It is appalling that President Obama would cut off federal healthcare dollars to Florida in an effort to force our state further into Obamacare,” Scott said in a press release announcing the lawsuit.
At press time no lawsuit had been filed. The decision to sue the federal government comes just two weeks after Gov. Scott switched his position on Medicaid expansion. In 2013 Scott said he supported expanding Medicaid and the governor reiterated that position while campaigning for governor last year.
The National Federation of Independent Business filed a lawsuit, NFIB v Sebelius against the federal health care law, alleging that the mandate to purchase health insurance was unconstitutional. While the court upheld the law in a 5-4 opinion it did rule that a section of the law that allowed the federal government to withhold Medicaid dollars from states that refused to expand Medicaid to low income uninsured people was unconstitutional because it would coerce states to expand or lose funding.
Department of Health and Human Services acting Secretary Vikki Wachino sent a letter to Medicaid Deputy Director Justin Senior on April 14 noting 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.”
She added that the expansion was the best way to support the health care needs of “low income Floridians and Florida’s health care 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.”
Deputy Medicaid Director Justin Senior responded to the letter with one of his own accusing the federal government of “coercing” the state and warned that position violated the Supreme Court of the United State’s rulng in NFIB v Sebelius.
The federal government said that Florida, “is free to implement Medicaid expansion or not.”
But LIP is not part of the a broader optional time-limited expansion demonstration project, made possible by a waiver.
“(Florida) is seeking an additional optional extension which raises a different question: whether it promotes the objectives of the Medicaid statute to use demonstration authority when the state has statutory options that would better serve the low-income population,” CMS said in a prepared statement in response to the lawsuit
The impending loss of $2 billion in Low Income Pool money and Medicaid expansion has been at the center of a budget impasse. Legislative leaders acknowledged April 15 that the 2015 regular session will not end on time because the chambers will not be reach accord on the budget.
The Senate includes $4 billion between the continuation of Medicaid supplemental payments called Low Income Pool dollars–which are set to expire this summer– and expansion of Medicaid under the federal health care law, whereas the House budget doesn’t contain the money.
CMS warned Florida one year ago tht it would not extend LIP to Florida and that the money would expire this summer. The $2 billion is used to fund hospitals, federally qualified health centers, graduate medical education and Medicaid managed care plans.
Senate President Andy Gardner in a statement said that he respects Scott’s authority to “protect the state’s i interests in the way he sees fit” but said the federal government is under no authority to continue to fund LIP.
“From where I sit, it is difficult understand how suing CMS on day 45 of a 60 day session regarding an issue the state has been aware of for the last 12 months will yield a timely resolution to the critical health care challenges facing our state.”
