House And Senate Agree On LIP Funding; House Healthcare Bills Still Pending

Jun 12, 2015

Credit Tallahassee Memorial Hospital / TMH

Florida lawmakers have reached a deal on one of the most contentious issue facing the legislature this year—how to fill a billion-dollar hole.  The move comes a week after the House torpedoed the Senate’s Medicaid Expansion plan.

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The deal reached by lawmakers would keep the Low-Income Pool program at $2 billion—roughly where it is now. The move comes after the federal government told the state it would reduce its contribution to the program—resulting in a nearly 55 percent cut. Lawmakers, as noted by House Health Care Committee staff member Eric Pridgeon, have come up with a way to fill in the rest.

Pridgeon says the legislature gets the program back up to $2 billion by increasing payment rates in other programs that get a federal match. It will also put $400 million in  state money into boosting the program to draw down additional federal dollars.

House Speaker Steve Crisafulli says the deal has helped moved state budget talks forward. While there are several issue still pending, like environmental funding and education, Crisafulli says the process is now going smoothly.

“I don’t see anything out there that’s still an outlier but certainly you never know what can come about. Things are going well," he said.

But as the legislature inches closer to a state budget deal the battle over healthcare is not over.  the House approved its version of healthcare reform: focusing on issues its leaders say will reduce costs.

One proposal gets rid of regulations dictating where hospitals can be built. The program is called, “certificate of need” and its premise is a hospital or other healthcare facility should be built when there’s a need in a community.

But Rep. Jason Brodeur, R-Sanford, thinks the process is outdated and hinders competition, “because Capital costs are so high in healthcare facilities, it is thought that limiting those expenditures you’ll will put a cap on expenses. However, whether or not CON accomplishes this is in question. Various studies indicate CON programs do not reduce costs.”

Brodeur says 22 other states have dropped their certificate of Need, or CON rules. The program is getting targeted by Governor Rick Scott, who believes more competition, not regulation, is what drives down costs. But Rep. Janet Cruz, D-Tampa, says eliminating the regulation could also hinder access to uninsured and poor patients.

“The elimination of certificate of need could result in care gaps for the less affluent, the rural areas and the inner city communities. The market forces simply won’t encourage competition for the uninsured. That’s just the way this works," she said.

The House also approved measures to give advanced registered nurses the ability to prescribe schedule I drugs and a plan to revamp state employee health insurance. The proposals are now before the Senate. And the chamber is still simmering over simmering over a house vote that killed its top priority—Medicaid expansion under the Affordable Care Act. Senate President Andy Gardiner says the House bills don’t meet the senate’s desire to see more people insured.

“But we’ll give them their due and if they’re good policy and they make good sense, we’ll move them.”

Still the votes are getting the legislature closer to a final budget, which has to be in place before the start of the July first fiscal year. Gardiner expects the legislature will vote on a state spending plan on the 19th—a day before the legislature is set to conclude its special budget writing session.