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Legislators have one more plan for federal Medicaid money: do nothing

As the clock winds down on the legislative session, Florida lawmakers are sending signals that they are likely to end the session without resolving the issue of whether the state should accept federal Medicaid money to insure the poorest in Florida.

 “It’s not something you put together in a week,’’ said Sen. John Thrasher, R-St. Augustine, chairman of the Senate Rules Committee and a close advisor to Senate President Don Gaetz. “It’s a very big, complicated issue and these issues take some time.”

He said he does not expect there would be any political repercussions if the Republican-led Legislature waits another year, even though it would mean forgoing for one year at least the estimated $5 billion in federal funds that could be drawn down under the plan to implement Medicaid expansion.

“There is no fallout,’’ Thrasher told the Herald/Times on Monday. “Anytime you walk away from something, there is going to be someone who is not happy. On something like this, however, it needs to be done right.”

Business groups, the Florida Hospital Association and the union that represents health care workers have launched television and lobbying efforts to urge lawmakers to implement a plan that draws down the federal money. If legislators adjourn their 60-day session on May 3 as scheduled without resolving the issue, those groups said Monday they will work to keep pressure on lawmakers to resolve the issue before next year.

 “This issue doesn’t end the last day of session,’’ said Tom Feeney, executive director of Associated Industries of Florida on Monday. The lobbying organization represents several hospitals and health care providers. “The pressure continues to build and the pressure will get worse on people,’’

Feeney, a former House speaker and congressman from Orlando, believes that if legislators fail to resolve the issue the health care industry will work on House Republicans to shift their thinking and find a way to cover one million Floridians who could be eligible for coverage.

“Right now it’s only the providers in the health industry that are screaming and hollering but, as the ramifications actually kick in, where you’re going to have hospital cutbacks and services cutbacks and businesses around the state get their bills for insurance, I think it’s going to become increasingly apparent that it makes no sense to walk away from $5 billion a year,’’ he said. 

The governor could call lawmakers back into special session, Feeney said, but only if there is a resolution worked out ahead of time, he said.

“A special session, to be successful, has an outline of an agreement before they go into session,’’ he said.

With less than two weeks left of the 60-day session, legislators are at a standstill over how to address the issue of whether or not to implement Obamacare’s Medicaid expansion. The House has firmly refused to budge on its position that it will not accept federal Medicaid money and the Senate has countered with a plan to accept the money but steer it into a privately-run program.

That leaves Gov. Rick Scott in the middle. He supports the Senate plan, wants the state to accept the federal government’s offer to pay for 100 percent of Florida’s cost for the first three years, and is clearly not ready to back down.

“Both the House and Senate know exactly where I stand,’’ Scott told reporters on Monday.

He repeated his support for the proposal by Sen. Joe Negron, R-Stuart, to accept the federal money but limit who is eligible for the program by steering it into a privately-run program modeled off of the state’s successful Florida Healthy Kids program.

“While the federal government pays 100 percent, how could we in good conscience deny access to health care,’’ Scott said. He noted that companies with employees who could be covered by the federal money will face additional federal taxes  if the state doesn’t offer the coverage.

“We don’t’ have a choice about the taxes,’’ Scott said. “We have a choice whether we can take care of those who don’t have health care.”

House Speaker Will Weatherford refused to say on Monday whether the House is prepared to walk away from the issue when it adjourns next week. 

 “There’s probably 500 things we have not agreed to at this stage…details get worked out in the wee hours of the session,’’ he said. “We believe there is time to pass our plan and have the Senate take a look at it.”

Weatherford has said that if it's a choice between taking federal money or going home, "we'd prefer to go home." 
Meanwhile, the Florida Remedy, an advocacy organization led by the Florida Hospital Association, announced Monday it has launched a television campaign in several cities -- Miami, Tampa, Orlando, West Palm Beach, Jacksonville, Ft. Myers, Pensacola, Tallahassee, Panama City, and Gainesville –  urging lawmakers to implement a plan to accept the federal funds.

Feeney believes there will be mounting pressure from the public if lawmakers adjourn and do nothing.

 “In districts around the state, there is likely to be some serious fallout,’’ he said. “Our bottom line is, you just can’t walk away from $5 billion in recurring funding and then ask businesses and taxpayers to go back again and pay for the one million uninsured.

“The uninsured get health care. They’re going to be covered,’’ he said. Any proposal “that doesn’t leverage federal resources basically says Florida taxpayers have to pay twice for the uninsured.”

Another point of pressure, Feeney said, will be the state’s bottom line. Moody’s Investor Services, he said, has warned that state’s that reject federal money for health insurance coverage could face financial repercussions.

“They made it clear that states that simply reject federal money are risking the state creditworthiness and the health of their hospital systems,’’ he said.