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Scott Reverses Course, Opposes Medicaid Expansion

Gov. Rick Scott
Associated Press
Gov. Rick Scott

Gov. Rick Scott reversed course Monday, saying he no longer supports Medicaid expansion as talks break down between Florida and its request for the federal government to extend funds to hospitals that serve low-income patients.

Gov. Rick Scott
Credit Associated Press
Gov. Rick Scott

Scott wants the federal Centers for Medicare and Medicaid Services to give Florida about $1 billion in hospital funds, but the feds have been denying that request for about a year, standing firm that the funds will end June 30.

Negotiations between state and federal health officials turned ugly in the past week, with the state accusing federal officials of walking away from discussions and sending a series of frenzied press statements warning that a key federal health official was going on vacation and talks had dissolved.

Federal health officials have denied the claims and said they remain in contact with the state.

The hospital fund negotiations have spilled over to Medicaid because advocates say the hospitals wouldn’t need as much federal funding if the state expanded Medicaid to 800,000 Floridians because the hospitals would have more paying customers.

The federal government has offered to pay the entire Medicaid expansion bill for the first few years and then phase down its funding to 90 percent, but Scott and House Republicans are concerned officials won’t make good on that promise.

Scott, who started his political career running TV ads against the federal health law, shocked many when he came out in support of Medicaid expansion in 2013 in an emotional speech, calling expansion a compassionate and common sense solution. He’s since backed away, saying in recent years that he has other priorities but wouldn’t stand in the way if the Legislature acted.

“Our priority is to cut more than $600 million in taxes this session and get K-12 education funding up to record levels while holding the line on college tuition. We still have several weeks left for budget negotiations; however, 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 first released to The Associated Press.

The growing feud over the hospital funds and Medicaid expansion has flustered Tallahassee lawmakers as they try to finalize a new state budget before the end of the session on May 1.

The Senate crafted a replacement program that it wants the federal government to consider that would take billions in federal funds so Medicaid recipients could purchase private insurance through vouchers. Senate leaders have said they will not vote for a budget if it requires large cuts to hospitals. But House Republicans, who are opposed to any expansion of Medicaid, have contended that the federal government could renew the hospital money without expanding Medicaid coverage.

Senate President Any Gardiner, R-Orlando, released a statement in reaction to Scott’s change.

“The Senate shares concerns raised by Governor Scott and the Florida House regarding the federal government’s ability to fund an expansion of coverage for the uninsured. For this reason, the FHIX program authored by the Senate includes conservative guardrails that would bring the program to an end if the federal government fails to meet its obligations to Florida,” his statement 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.”

Sen. Tom Lee, the Brandon Republican in charge of the Senate budget, held a nearly hour long meeting last week with Scott, where the GOP governor talked about health care, but never once discussed, or showed any support for the Senate “premium assistance” plan as Lee called it.

“It was clear to me that he wasn’t supportive of Medicaid expansion,” Lee said. “Or at least all the comments he was making would have left me with the opinion that he was not supportive of Medicaid expansion at least not at this time.”

Lee, however, said that if legislators do not address health care funding issues, including the Senate proposal, it could make it difficult to find agreement on other issues that Scott wants passed this year.

“There’s no question that this premium assistance program controversial,” but Lee said that if nothing is done then “It has the potential of creating a roadblock that precludes from getting things done and delivering on the governor’s priorities.”

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