Federal offer could help state avert shutdown

Federal offer could help state avert shutdown

ORLANDO, Fla. — It's not what it was, but it may be something.

That is the basic reaction from lawmakers on Thursday as they receive news that the Centers for Medicare and Medicaid Services is offering to continue low-income pool funding at a level of $1 billion for next year.

Florida had been told the pool of money was going away.

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However, CMS director Vikki Wachino is now offering the state a two-year extension, offering Florida $1 billion for the 2015-2016 fiscal year and $600 million for the 2016-2017 fiscal year.

While the money should help the state balance its budget and avoid a government shutdown, it is roughly half of what the state received in the previous year and may only prolong the state's current problems with healthcare.

"It remains clear that a sustainable long-term solution is needed. As you are aware, the Senate has proposed a Florida solution that will promote the well-being of our constituents and protect the fiscal health of our state," wrote Senate President Andy Gardiner (R-Orange County) in a letter to Florida Senators on Thursday.

Low-income pool funding is money delivered to Florida hospitals to cover the cost of taking care of residents without insurance or with inadequate insurance.  In the 2014-2015 fiscal year LIP funding in Florida was $2.2 billion.

In late April, the Florida House of Representatives adjourned three days early over an impasse on health care and Medicaid expansion.  The impasse on health care was central to the legislature's inability to pass a budget.  In his January budget recommendation, Governor Rick Scott included $1.3 billion in LIP funding.

However, when Health and Human Services informed the state that the funding would go away, a division emerged between the Florida House and Senate.  The Florida House passed a budget without LIP funding, while the Senate drew up a plan for Medicaid expansion, which would have tapped federal dollars to cover the disappearance of LIP.

In the letter from CMS to Florida's Agency for Health Care Administration, Wachino cautioned that the extension of LIP funding was designed to be temporary in 2014, hinting that this most recent offer will be the last, writing "when CMS agreed to a temporary one-year extension of LIP in 2014, CMS made clear that is expected Florida would use the year to develop reformed Medicaid payment systems and funding mechanisms."

Senators said the $1 billion will help balance the budget and avoid a state government shutdown gives the state some time to draft  a plan to address healthcare.

"This gives us an opportunity to look our model of delivery of services, we can improve on what we are doing right now," said Sen. Alan Hays (R – Lake County). "We have a Medicaid program that is high in expense and low on quality and the people of Florida deserve better."

Even with the LIP money, lawmakers point out the state is still facing a budget hole of about $1 billion.

"We’re still going to have to make up somewhat of a difference, which could lead to a deficit and some cuts unfortunately," said Sen. Darren Soto (D – Orange County).

Florida lawmakers are scheduled to return to Tallahassee in June to hold a special session needed to pass a state budget.