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Legislature approves Medicaid plan derided by counties

Despite widespread concerns from lawmakers that the proposal was unfairly burdensome to counties, the Legislature approved changes to the Medicaid program on Friday night.

The House approved HB 5301 on a 73-36 vote that split mainly along party lines. However, several Republicans joined the Democratic Caucus in voting against the measure.

Their beef was provision in the legislation that forces counties to pay back roughly $300 million in disputed Medicaid bills over 5 years. The state will withhold revenue sharing dollars from the counties for both the backlog and future Medicaid payments.

The vote in the Senate was much closer and showed the tough decisions lawmakers faced in a bill that had provisions they both liked and disliked. For example, HB 5301 also included a provision that allows state employees to enroll their children in the KidCare health insurance program.

The 23-17 vote in the Senate included four Democrats who voted “yes” and nine Republicans who voted “no.” Senate Minority Leader Nan Rich, D-Weston, voted in favor of the legislation.

“For me, it’s kind of a painful choice,” said Rich, who had pushed for the KidCare changes for years.

Senate leaders promised to continue to work with counties to come up with a fair process for them to dispute the Medicaid bills. But they also said counties should have to pay the state what it’s due.

“Clearly the evidence is there that they owe it,” Sen. JD Alexander, R-Lake Wales, said. “We’ve provided it a discount. We’ve provided a longer repayment plan for the backlog.”

Florida Association of Counties spokeswoman Cragin Mosteller said she was “disappointed” that both chambers approved HB 5301 and the organization will encourage Gov. Rick Scott to veto the measure.