After six months of political jockeying, litigation, and one-upsmanship Florida and the federal government have agreed in principle to $1.6 billion in supplemental Medicaid funds over the next two years.
Most of those funds, $1 billion, have been allocated in the budget Gov. Rick Scott signed into law on Tuesday. A little more than $600 million, though, still needs to be negotiated between Florida and the federal government.
Which means, just because the special session is over, discussions over who gets what aren’t. And that’s just fine for state Sen. Tom Lee, the chief budget writer in the Florida Senate.
“We really need to get out in front of this,” Lee told Florida Politics, saying that discovering LIP was not going to be renewed at the $2 billion level in March was too late in the process.
“It was disappointing for me to learn in March that our budget might have been built upon a fiction of federal dollars that wasn’t going to be available,” Lee said. “Now that we know, I think it’s great that we can begin working on a model in the fall. And if it’s put to bed early, we can build our budget based on reality and avoid these conflicts based on allocations.”
In her letter to Florida Deputy Secretary for Medicaid Justin Senior, Centers for Mediare and Medicaid Services Director Vikki Wachino said Florida needs to submit a new distribution formula for the Low Income Pool program by October 31, 2015. The goal is to have the formula approved by the federal government by December 31, 2015.
That’s just before the start of the 2016 session, where lawmakers will meet from January 12 through March 11. They will work on a 2016-17 state fiscal year budget.
“Florida may not claim federal financial participation for LIP payments [in 2016-17] until a new methodology is approved by the federal government,” the letter notes.
The Florida Legislature could not pass the 2015-16 budget because the state did not know how much Low Income Pool money to expect. Though the federal government had advised Florida in writing in April 2014 that the $2 billion LIP program would not exist in its present form beyond this summer, Scott built his proposed budget assuming the $2 billion would be available.
And while Senior hoped to secure an agreement in principle on the future of LIP by April so the Legislature could pass a budget, the two sides weren’t able to agree on the amount of supplemental funds. Florida continued to push for the $2 billion limit and the federal government advised Florida the dollar amount was too large.
The governor sued the federal government in court in an attempt to require the federal government to continue funding at that level. Scott withdrew the lawsuit Thursday.
To prepare for the 2016 session the Legislature will begin meeting in September. State Sen. Aaron Bean has asked for the creation of a joint legislative task force, so the chambers can examine some of the more controversial healthcare issues, including the elimination of certificate of need for new hospitals, giving the green light to longer stays at ambulatory surgical centers, and approving recovery care centers, which could care for patients who are rehabilitating from surgery.
Legislative leadership was on board with the joint legislative committee. It’s not clear whether a new LIP distribution formula would be part of the task force’s conversations.
Ballard Partners Tampa office manager Jan Gorrie, who represents some large urban hospitals, said “there’s no rest for the weary.”