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In Reversal, Scott Opposes Expanding Poor’s Health Insurance and Opens $2.2 Billion Budget Hole

| April 6, 2015

He says no to $47 billion in federal aid. (© FlaglerLive)

He says no to $47 billion in federal aid. (© FlaglerLive)

Adding more drama to a $5 billion budget standoff between Republican legislative leaders, Gov. Rick Scott on Monday reversed course on his one-time support for providing health coverage for low-income Floridians as part of the federal health-care law known as Obamacare.

Scott blamed his rejection of a state Senate plan on a distrust of the federal government, the result of an apparent breakdown in negotiations between his administration and federal officials over a program that pays hospitals and health providers for unreimbursed care. The feds contribute at least $1.3 billion a year toward the Low Income Pool, or LIP, program.

The U.S. Centers for Medicare & Medicaid Services last year gave the state a one-year extension on LIP — set to expire on June 30 unless Scott and federal officials reach a new agreement — but the Obama administration is unwilling to renew the program in its current form.

The Senate and Scott included $2.2 billion to cover the costs of LIP in their budget plans, but Republican House leaders did not.

To sweeten the deal for the feds, the Senate linked the revised LIP program with another $2.8 billion for the “Florida Health Insurance Affordability Exchange,” or FHIX, to pay insurance premiums for about 800,000 Floridians with incomes up to 133 percent of the poverty level. Under the Affordable Care Act, the federal government would pay the state about $47 billion over the next eight years for the program. That money would come from a pot that is earmarked for Medicaid expansion across the country, though Senate officials have tried to distance their proposal from the Medicaid program.

The governor is in a standoff with federal health officials, and with his own Senate leadership.

The House has balked outright at a Medicaid expansion — or anything that looks like a Medicaid expansion — and on Monday Scott joined the chorus of Republican naysayers.

“… Given that the federal government said they would not fund the federal LIP program to the level it is funded today, it would be hard to understand how the state could take on even more federal programs that CMS could scale back or walk away from,” Scott said in a statement.

As a candidate seeking reelection to a second term, Scott gave tepid support in 2013 to a similar Senate plan but failed to campaign for the doomed proposal’s passage.

“While the federal government is committed to pay 100 percent of the cost, I cannot, in good conscience, deny Floridians the needed access to health care,” Scott, who made his fortune in the hospital industry, told reporters in February 2013.

It may not come as a surprise that Scott, who ran as a tea party “outsider” in 2010, has shifted his position on Medicaid expansion. The conservative Americans for Prosperity has targeted Republican senators, including Senate President Andy Gardiner, for supporting the issue, part of what was once considered a cornerstone of the Affordable Care Act but which the U.S. Supreme Court left up to the states in a seminal ruling upholding the federal law.

Scott’s turnaround didn’t persuade Gardiner to back down from his chamber’s proposed fix for hospitals and low-income, uninsured Floridians.

In a statement issued Monday in response to Scott, Gardiner made a veiled threat about Scott’s push for record-high public school funding and nearly $675 million in tax cuts.

“The Senate also shares the governor’s commitment to tax relief and record funding for education; however, if our state is forced to make up the difference of $2.2 billion in hospital funding, every area of our budget will be impacted,” Gardiner, R-Orlando, said. “Moving forward the Senate will continue to advance the conservative, Florida-based, free-market solutions we have proposed. We believe these innovative, bipartisan proposals can gain the approval of our federal partners, and we stand ready to meet with the House or Governor Scott at any time to discuss a way forward.”

Without telling Scott, Gardiner last week dispatched two senators to meet with federal health officials to discuss the Senate’s plans. The next day, Scott’s office announced that the Obama administration official in charge of negotiations had abruptly ended the talks. It was later learned that the lead federal negotiator, Eliot Fishman, had left the country for a long-planned trip to Israel.

Senate budget chief Tom Lee, who met with Scott and his top aides late last week, said Monday that the governor made it clear “he was no big fan of dealing with the uninsured in Florida.”

Lee likened the Legislature’s position to being in a “box canyon,” another term for a three-sided, deep ravine with only one way in or out.

“Behind us, we have the Centers for Medicare & Medicaid Services telling us that we don’t have a budget solution on the one hand. And we have the governor saying you can’t fix this problem using general revenue. And on the other hand, we’ve got people saying they’re re not going to talk about insuring low-income Floridians, which is part of the problem here. We have too many Floridians creating this unreimbursed care. So we’re very much in a box canyon right now,” Lee, R-Brandon, said.

A fiery speech last week by Lee’s House budget counterpart Richard Corcoran, slated to take over as House speaker after the 2016 elections, deepened the divide between the two chambers over the coverage expansion.

“We’re not dancing this session, we’re not dancing next session, we’re not dancing this summer,” Corcoran, R-Land O’Lakes, said before a House vote on the budget Thursday

The showdown between the two chambers, coupled with the breakdown in talks between the Scott administration and federal officials over LIP, heightens uncertainty about whether lawmakers will finalize budget negotiations before the scheduled May 1 end of the legislative session.

Politically, the House has more to lose than the Senate by caving on the Medicaid-expansion issue, said GOP strategist J.M. “Mac” Stipanovich.

“There’s only one person here who has to prevail in his position, and that’s Rep. Corcoran. Can President Gardiner not exert himself? Can he not lay waste to all the priorities of the House? Can he not show the Senate’s strength and its outrage? Of course he can. He doesn’t have to win on Medicaid. He has to be strong and purposeful and he has to punish what is a pretty flagrant breach of protocol. But he doesn’t have to win on Medicaid,” Stipanovich said.

Meanwhile, House Republicans — and Scott — are relying on the Obama administration to come up with the LIP money left out of the House spending plan.

“In an ironic way, the perception of victory for the conservatives probably lies in the hands of their arch-enemies in Washington,” Stipanovich said.

–Dara Kam, News Service of Florida

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14 Responses for “In Reversal, Scott Opposes Expanding Poor’s Health Insurance and Opens $2.2 Billion Budget Hole”

  1. A.S.F. says:

    He’s an idiot AND a thief…Perfect tea Party (excuse me, Ronald Reagan Club) material.

  2. Flatsflyer says:

    The Dumb Floridians who voted for the Fraudster are getting exactly what they deserve. Nothing will change until the “Kochsuckers” finally ends up behind bars where he really belongs.

    • Registered "DemonCrat" says:

      Yes, the voters who supported Scott are getting exactly what they deserve (I’ve heard it compared to a chicken voting for Colonel Sanders). Unfortunately, the true democrats who want real change and progressive, productive policies are left with no choices in elections. For Governor, we had Scott, who is a teabagger by vote and action, or we had Christ, who is a moderate/conservative Republican.

      As long as the democratic party nominates conservative Republicans, we will continue to be one of the most backward states in the union.

  3. BR549 says:

    Here we go again.

  4. Rob says:

    He should be loving the Feds.

    They let him skate away untouched, unscathed and without prosecution for that massive fraud he was involved in.

  5. ted bundy says:

    oh well, back to the e.r. for health care and then the state eats the bills..good job florida

  6. Obama 2015 says:

    Alot of poor Republicans will be without affordable healthcare.. Thanks Obama!

  7. Sherry E says:

    Please get out there TODAY and vote for CHANGE!

  8. confidential says:

    Yes, vote Morley and Cox and start booting out the GOP feudalism from Tallahassee!

  9. Lancer says:

    You people make me laugh.

    First, is the false notion that Scott was ever, in any way, associated in the Columbia Healthcare fraud. There wasn’t a point, at any part of the federal investigation, where Scott was the focus. Better yet, Scott was never investigated for any wrong doing: none, nada, zip, zilch, zero! The people who spout this crap are the same gutless, vile that Harry Reid is. Harry Reid who, admittedly, LIED on the senate floor about Romney not paying his taxes during an election! Go get some therapy for that.

    Second, is completely ignoring Charlie Crist’s baggage and as a fetch and step boy for J. Morgan. Morgan…the trial lawyer who had an ad in December basically saying that “you should file that lawsuit you’ve been meaning to before the new year.” Morgan…who just loves the sound of his own verbal excrement, so much, that he buys countless ads on radio stations spouting about his morality. What? Money is only good if it’s supporting dem candidates, right? …and who cares that a candidate repeatedly changes his positions and sides to try and keep getting elected, right? Here’s a thought: Dems would have had a great chance to win the governorship…if they would have had a DECENT candidate.

    Lastly…the issue about healthcare. 0bam-bam-care is a federal idea, brought to you, solely, by the democrat party. 50% of the legislators who voted for this rubbage have been voted out of office. In fact, the dems have lost the house AND senate, mostly, as a result of this law. Millions of Americans have had their premiums increase. Many Americans have had their work cut to part time. 85% of the recipients are funded by taxPAYERS, the same place the insurance companies gets their losses covered! That’s right, libbers, the insurance companies(you love to hate) were bought and paid for by 0bam-bam(he promised to cover their losses). Scott is right, if the fed wants it, the fed can pay for it. The left loves to talk about Mass. healthcare…just not the fact that Mass was stealing from the fed to have to pay for it. Gripe on libbers, gripe on. Scott is merely reacting to a problem caused by one party. Lastly, we have the words of a libber genius, Jonathan Gruber, about how 0bam-bam care was passed admitting lies, deceit and fraud.

    The only good thing is that repubs have controlled the house enough to limit this law’s spending! But…we’ll have dems try to give 0bam-bam credit for that! Just like they try to give Clinton props when he had a Repub congress! Or the comparison of 0bam-bam to Bush…which begs the question: If Bushy was so bad, why do they compare 0bama to him? Aim low, hit the mark?

  10. Swizz says:

    Scott will just steal the 2.2 billion out of the Florida Retirement System like he did a few years ago. Biggest swindle in history.

  11. Sherry E says:

    How about some actual “FACTS” from a “credible” source saying that the since ACA was implemented patient harm has been massively diminished!

    This from the Washington Post:
    The Facts

    The 50,000 number is derived from a study, released on Dec. 2, 2014, by the Agency for Healthcare Research and Quality, an arm of the Department of Health and Human Services.

    The study looked at the impact of the Partnership for Patients, a $460 million program funded by the (ACA) health law that ties together 3,800 hospitals in 27 “health engagement” networks, with the goal of reducing 10 categories of “patient harms,” such as adverse drug events, pressure ulcers and catheter-associated urinary tract infections. The networks collaborate to identify possible solutions to common problems and then circulate those ideas among the various hospitals, with the goal of reducing preventable hospital-acquired conditions (HACs) by 40 percent and 30-day hospital readmissions by 20 percent.

    The study admits that “the precise causes of the decline in patient harm are not fully understood,” but it notes that “the increase in safety has occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events” though programs such as the Partnership for Patients.

  12. Groot says:

    LIP, DSH, HCAP same thing. When I administered DSH proram in Ohio for hospitals, called HCAP there, we made millions off the feds with federal matching dollars. Don’t be a fool Rick play the game and take the federal money. Other republican governors do, Gov Kasich of Ohio does. Speaking of Kasich, I think he’ll burst onto the national stage soon and be a success.

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