May 29, 2015

Conservative Americans for Prosperity takes to TV to blast Florida lawmakers over Medicaid expansion


Americans for Prosperity, a conservative group backed by the industrialist Koch brothers, is continuing to campaign against Medicaid expansion under Obamacare in Florida.

The group plans to launch a new television ad timed with the start of the special Florida legislative session, which begins Monday (a longer web version of the spot is below). AFP has also sent fliers to voters to targeting Republicans in the state Senate who back Medicaid expansion.

"The Florida Senate's Medicaid expansion plan is wrong for Florida," AFP state director Chris Hudson said in a statement. "The only thing that is certain is that Florida families who depend on this already bloated program will have an even harder time getting care and, like other states' expansions, it could cost billions more than expected, ultimately forcing legislators to raise taxes or make cuts from other essential services."

Hudson's father is state Rep. Matt Hudson of Naples.

A Healthy Florida Works Coalition, which supports Medicaid expansion as proposed by the Senate, has been airing its own ad in support of those lawmakers.


May 28, 2015

Scott's LIP plan would cut $214 million from hospitals, most in South Florida

Gov. Rick Scott released details of his latest proposal to draw down $2.3 billion in federal Low Income Pool funds on Thursday. While the formula is higher than previously announced, it does not use any state dollars to backfill the loss but it cuts reimbursements to hospitals by $214 million.

Hardest hit are hospitals that do the bulk of the state's charity care. Among those facing the deepest cuts are: Jackson Memorial (-$34.5 million), Broward General (-$22.3 million), Shands in Gainesville (-$34.5 million), Shands in Jacksonville (-$36.5 million) and All Children's Hospital in St. Petersburg (-$12.9 million.)

Under the plan, announced by the Agency for Health Care Administration in a letter to the federal government on Tuesday, the state would not lose $1 billion in federal health care money as previously suggested but the money would be offset by local hospitals and local governments, which would raise $900 million in financing to draw down $1.2 billion in federal Low Income Pool funds. The financing arrangements are known as intergovernmental transfers. 

As a return on their investment, hospitals would be rewarded a 10 percent profit -- a cost to the program of about $100 million. The state would then use the $1 billion promised by the federal government in Low Income Pool funding to reimburse teaching hospitals and increase patient reimbursement rates.

Continue reading "Scott's LIP plan would cut $214 million from hospitals, most in South Florida" »

Miami groups petition for Medicaid expansion at state Rep. Jose Oliva's office

via @chabelih

At a busy corner in the ZIP code with the highest number of Obamacare enrollments in the nation — 33012 in Hialeah —demonstrators armed with 30,000 signatures knocked on the door of state Rep. Jose Oliva’s office Thursday hoping to gain his support on the issue that has polarized Florida’s lawmakers: Medicaid expansion.

About 30 people showed up for the rally led by SEIU Local 1991, a union representing 5,000 healthcare workers in the Jackson Health System. They sought to convince Oliva — who was not in his office — and other House Republicans opposing expansion to change their minds before the start of the legislative special session next week.

The Affordable Care Act, also known as Obamacare, includes a provision to expand Medicaid. Florida is among the 18 states that have not chosen to expand and a bitter dispute between Republicans in the House and Senate over the issue forced an early end to the regular session.

The groups delivered the signatures, collected over several months from around the state, to Oliva’s second-floor office at a shopping center, urging him to listen to his constituents.

“His constituents are telling him: ‘We want healthcare. We are buying healthcare under the Affordable Care Act,’” said Martha Baker, president of the local SEIU, before leaving the petition with Oliva’s secretary.

More here.

May 27, 2015

South Florida lawmakers take up Medicaid expansion at health forum

via @chabelih

With a special legislative session set for next week, South Florida lawmakers, hospital representatives and health groups gathered Wednesday to discuss Medicaid expansion, the future of healthcare in Florida and a looming Supreme Court decision on subsidies.

Sen. Rene Garcia, a Miami Republican who chairs the Senate healthcare budget committee, in a panel discussion with Sen. Anitere Flores, R-Miami, and Rep. David Richardson, D-Miami Beach, said a healthcare crisis still exists in Florida after the Legislature adjourned without passing a budget. About 850,000 Floridians fall into the healthcare “gap” created when Florida chose not to expand Medicaid.

Garcia said he is frustrated with the House’s refusal to explore options for Medicaid expansion: “It just makes no sense to me that you cannot sit in a room and have a conversation as to how we are going to fix the problem.”

The panel offered some hope of a solution to the impasse, noting that House appropriations chair Rep. Richard Corcoran, R-Land O’Lakes, called the Senate’s proposed Medicaid expansion plan “exciting” earlier this week, with the caveat that the Senate guarantees it will take up several other House proposals.

Still, no House Republicans attended the Health Foundation of South Florida’s forum, though they were invited.

More here.

White House 'disappointed' over Florida Medicaid-expansion impasse


President Obama's two-day stop in Miami has nothing to do with Florida's upcoming special legislative session forced by a disagreement over how to fund healthcare.

But the White House couldn't avoid a reporter's question Wednesday about the president's opinion on the opposition from statehouse Republicans to expanding Medicaid under Obamacare.

"We have demonstrated a willingness to work closely with state leaders to tailor solutions" to their residents, Press Secretary Josh Earnest said when asked about the issue in a conference call with Florida reporters. "The refusal of Republican officials in Florida to put the interests of their citizens ahead of their own political arguments is something that we've been disappointed by."

Obama arrives Wednesday afternoon for a pair of Democratic Party fund-raisers. Earnest's question-and-answer session was intended to delve into the president's visit Thursday to the National Hurricane Center, where he will ask people to prepare for the annual storm season that formally begins June 1.

Yet with Gov. Rick Scott and the GOP-controlled Legislature still at odds over how to craft a state budget in the special session that begins the same day, Earnest had to address the impasse. He said the U.S. Health and Human Services Department is open to a compromise -- if Florida is.

"There are officials at HHS who continue to be in regular contact with Gov. Scott's office, and we continue to be ready and willing to engage in serious discussions about a Florida-tailored Medicaid expansion proposal that would help 750,000 people in Florida get access to quality, affordable health coverage," Earnest said.

(The number is closer to 850,000 people, according to a different study than the one cited by the White House; the figure depends on how the uninsured are measured. Both studies rely on statistical formulas to update old data.)

May 26, 2015

House softens opposition to Senate health care plan as governor escalates it

Hours after the Florida Senate leaders thought they were addressing House criticism by offering up a modified FHIX health insurance plan, Gov. Rick Scott squelched their optimism by calling the proposal a tax increase that will "grow government."

“Florida’s economy is growing and this year we have over a $1 billion budget surplus,'' Scott said in a statement released by his office. "The Senate’s plan to expand Medicaid under Obamacare will cost Florida taxpayers $5 billion over 10 years."

He said "a budget that keeps Florida’s economy growing will cut taxes and give Floridians back more of the money they earn, not inevitably raise taxes in order to implement Obamacare and grow government." 

Scott's comments contrasted with the tone offered by Rep. Jose Oliva, R-Miami, a top House lieutenant and vocal critic of the Senate's health insurance plan.  

"It’s certainly moving in the right direction,'' he told the Herald/Times. "I do think that they are starting to move in the direction that we would hope they would move to. It will be interesting to see if the Senate will take up real cost cutting issues. The crisis in health care begins at the cost part of that equaton. Until we address costs there will never be enough expansion as those costs continue to rise." 

House leaders say they want to reduce the cost of health are by injecting competition into the health care arena with programs that eliminate certificate of need for hospital programs, allows for ambulatory surgical centers to compete with expensive hospital care, requires hospitals to to publish price lists, and allows nurse practitioners to prescribe medication and bypass physicians. 

May 21, 2015

Feds: Florida needs $1 billion for hospital funding

via @stevebousquet

TALLAHASSEE — The federal government told Florida on Thursday that the state will need $1 billion next year to maintain a hospital payment program that's at the center of a political stalemate preventing passage of a new state budget.

In a letter to state health officials, the U.S. Centers for Medicare and Medicaid services said the $1 billion would "maintain stability while the system transitions" to new ways of compensating hospitals for the high cost of treating poor patients, a program known as LIP or low income pool.

Tampa General Hospital, All Children's Hospital in St. Petersburg, Miami's Jackson Health System and Broward Health are among Florida's largest recipients of LIP money. In the current year, those hospitals were promised a total of $731 million in supplemental payments, provided through a blend of federal and local tax money that totals nearly $2.2 billion.

In their letter, the feds did not promise any LIP money. But a House Speaker Steve Crisafulli, R-Merritt Island, told lawmakers that the news is a "clear indication (that) Florida will receive a significant level of LIP funds, which will help us in our efforts to finish the budget by the July 1 deadline."

The $1 billion would revert to the level of LIP funding before 2014.

Senate President Andy Gardiner, R-Orlando, told senators that the news is further proof that a form of Medicaid expansion is the right solution.

"It remains clear that a sustainable long-term solution is needed," Gardiner told senators. "As you are aware, the Senate has proposed a Florida solution."

Continue reading "Feds: Florida needs $1 billion for hospital funding " »

May 20, 2015

Florida Republicans to Obama: Keep LIP program for hospital charity care


U.S. Sen. Marco Rubio and 11 other Republican members of Florida's congressional delegation sent a letter Tuesday to President Obama asking him to continue the federal Low Income Pool program in Florida.

The Health and Human Services Department plans to discontinue the current form of the LIP program, which provides hospitals with charity-care funding, by June 30. That has thrown Florida's healthcare budget into disarray, forcing a special legislative session beginning June 1 for lawmakers to craft a budget. The Senate wants to expand Medicaid under Obamacare to make up for some of the lost funding; the House doesn't. The feds say they want to work with the state to reach some sort of solution.

"HHS's refusal to continue LIP funding in Florida because the state has not expanded Medicaid is an inappropriate overreach and in direct contradiction to the Supreme Court decision," the Republicans' letter reads. It notes Jackson Health System in Miami would lose $237.2 million next year, and Mount Sinai Medical Center in Miami Beach would lose $16.2 million.

"We are requesting your immediate action to reverse HHS's decision to end LIP funding," the members of Congress wrote. "The well-being of Florida's low-income families will remain in jeopardy until your administration approves funding for these vital health services.."

Among the letter's co-signers were Miami Reps. Carlos Curbelo and Mario Diaz-Balart, and Ponte Vedra Beach Rep. Ron DeSantis, who is running for Senate in 2016.

May 13, 2015

Corcoran and Lee meet all day to discuss budget

The Legislature’s two budget chiefs met all day Wednesday to discuss ways to compromise on the impasse on Medicaid expansion, but don’t expect any breakthroughs, at least not yet.

House Appropriations Chair Richard Corcoran, R-Land O’Lakes said Wednesday’s meeting in the Capitol with Sen. Tom Lee, R-Brandon, was “super productive.”

But he also said it was “too early to say” when asked what, if any, common ground was reached. Lee and the Senate want to use federal Medicaid money to expand healthcare coverage; Corcoran and the House oppose that plan. That disagreement has held up a wider agreement on the state’s $80 billion budget. Lawmakers are scheduled to meet in the first three weeks of June during a special session to approve a budget. State government isn't threatened with running out of money until July 1, when the new budget year begins.

“The best part, from the House standpoint, was that it was the first real negotiation where there was give-and-take,” Corcoran said.

Corcoran did say he and Lee agree that both want a budget. A good thing, perhaps, for two budget chairs to agree on. But he hinted that desire might trump coming to a resolution on Medicaid expansion during the special session.

Asked if a discussion on expansion might be put off for a later date, perhaps at another special session, Corcoran replied that it was a “potential compromise and endgame.”

His negotiating partner, Lee, couldn’t be reached. Lee told the Associated Press that "a fair amount of progress" had been made Wednesday. Corcoran said Lee was joining him for wine and cigars later that night. He said, however, no major breakthroughs were expected at this gathering.

“It’ll be more social,” he said. “We won’t talk business.”

Scott asks federal health officials for guidance

Gov. Rick Scott floated a few broad ideas for expanding health care coverage in a letter to U.S. Health and Human Services Secretary Sylvia Burwell on Tuesday.

The letter, first reported by Politico, asked several questions intended to guide the governor's new Commission on Hospital and Healthcare Funding. Among them: Would the federal government be willing to give Florida a block grant to expand coverage? 

HHS has yet to respond.

Scott's letter came one day after he compared the Obama Administration to the Sopranos for allegedly coercing Florida into expanding Medicaid. Scott has also filed a lawsuit seeking to prevent the feds from linking expansion to the continuation of a federal-state hospital funding program known as the Low Income Pool.

Read the full text of the letter to Burwell here.