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LIP budget boost for hospitals looks unlikely

@MichaelAuslen

It doesn’t appear likely that state lawmakers will shore up a shrinking fund to reimburse hospitals for unpaid health care procedures for the poor.

Last week, the federal government told the state that the Low Income Pool (LIP) would be capped at $608 million, a drop from the $1 billion in the fund this year and more than $2 billion last year.

“We’re going to have to live within our means,” said Sen. Rene Garcia, R-Hialeah, chairman of the Senate Health and Human Services Appropriations Subcommittee. “Hospitals are going to have to tighten their belts as it relates to LIP funding.”

There’s a big caveat here: It’s still early. The state budget process is just beginning, and lawmakers could put money into the safety-net hospitals through other methods to help balance out their bottom lines.

Garcia said he doesn’t expect that to happen, or Medicaid expansion, but he’s willing to work with the House on ideas. For their part, the House Health Care Appropriations chairman isn’t yet ready to say what he thinks will happen.

“It’s a little early to be definitive and tell you, ‘No, we’re not going to backfill,’ or ‘Yes, we are going to backfill,’” said. Rep. Matt Hudson, R-Naples.

Garcia said that he would be surprised if the Legislature handed down more money to offset the LIP shortfall, beyond the roughly $400 million they included in last year’s budget. That will likely leave the safety net hospitals about $200 million short of the current year.

“I just don’t see the appetite for that this year,” he said. “I personally don’t think that’s going to happen.”

But, he said, every option should be on the table and lawmakers should be having conversations about how to make sure the hospitals don’t go under. There are bigger questions on the horizon, as well, including the possibility that some counties that pay into the LIP could pull their support without guaranteed returns on investment.

“The problem I’m going to have is how do you keep those donor communities and those donor hospitals continuing to donate the money?” he said.

Hudson says his focus isn’t on LIP right now. It’s on his radar, but there are other budget questions he’s thinking about.

“While the LIP is important, that senior or that veteran or that newborn is just as important to me, whether they’re involved with LIP or not,” he said. “And so it’s important that we strike the balance across all categories.”

Last week, after the U.S. Centers for Medicare and Medicaid Services announced that it wouldn’t allow the LIP to surpass $608 million, the Safety Net Hospital Alliance of Florida expressed concern about the amount of taxpayer support they would have.

Safety Net hospitals are committed to working with Gov. Rick Scott and state lawmakers to ensure Florida continues to receive adequate funding to help offset the costs of providing the best health care to the state’s sickest, most vulnerable citizens,” SNHAF executive director Tony Carvalho said in a statement. “Any further cuts to the LIP can be expected to impact hospitals’ ability to maintain the vast array of highly specialized and innovative services to their patients.’"

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