House, Senate Healthcare Dispute Shows Up In $4B Gap In Spending Plans

Mar 20, 2015

Matt Ross, 23, is one of more than 800,000 Floridians stuck in what's called the Medicaid coverage gap. The Medicaid issue is diving the Florida legislature as it tries to craft a budget.
Credit LHatter / WFSU News

Continued uncertainty over federal health funding is causing budget pains in the Florida legislature. The House and Senate have a $4 billion  gap in their proposed spending plans for the upcoming fiscal year—and that’s largely due to disagreements over the biggest part of state spending: Medicaid.

The first floor of the Capital is swarming with people dashing back and forth—some pushing frantically at the slow-running elevators, others giving up—and dashing up the stairwells instead. Off to the side, is 23-year-old Broward resident Matt Ross.

“I don’t have any services, I work a part time job, holding a sign at a busy highway," he explains. " I’ve been looking for jobs, but due to limited bus schedule and autism, I can’t work a register and a list of other job functions.”

Ross joined the healthcare advocacy group Florida Chain in support of a Senate plan that draws down tens of billions of federal dollars to insure about a million low-income Floridians in what’s known as the Medicaid coverage gap. They make too much for the state’s current Medicaid program, but too little for the federal government’s insurance exchanges.

The Senate’s budget proposal includes that money. The chamber is also crafting a plan to include another $2 billion in federal funding called the Low-Income Pool, which expires in June. But neither of those federal programs, are in the House’s budget. And they won’t be,House Healthcare Appropriations Chairman Matt Hudson told his committee earlier in the week.

“It would be premature of us to speculate what parameters CMS will give us. Therefore we have not budgeted LIP funding in this proposal. As we receive more definitive answers from CMS, we will update our budget proposal, and we hope to have more definitive answers prior to the end of session.”

CMS is the federal Centers for Medicare and Medicaid Services. Negotiations are ongoing when it comes to the low-income pool. And the House remains opposed to using the additional federal Medicaid dollars.

The House budget proposal clocks in at $76.2 billion. That’s about $1 billion less than what Governor Rick Scott has proposed. It’s also $4 billion less than the Senate’s whopping, $80 billion spending plan. Here’s House Appropriations Chairman Richard Corcoran commenting on that gap.

Right now, that chasm between the House and Senate looks sizeable but I’m an optimist, I think we’ll get it worked out. I think President Lee is a great guy, the Speaker is working with President Gardiner and I think those are things we work through as the weeks go on," he told reporters Thursday.

Meanwhile, other parts of Florida’s budget aren’t shaping up the way lawmakers may have hoped.  The potential loss of federal money, coupled with the House’s continued reticence toward expanding Medicaid—means fewer dollars for areas like Education, as former Senate President Don Gaetz explains.

“Notwithstanding that, The President has provided additional funding to us. Probably not as much as he or any of us would have hoped if circumstances had been different, but the fact is we will have additional funding in the proposal from this committee—a 4 percent increase in FEFP funding," Gaetz said.

The House and Senate’s education spending plans also fall short of what Governor Rick Scott wanted, but they still represent a slight increase in overall education funding from the current year.

Meanwhile, there’s one place in the budget that is seeing a boost—environmental spending…although that too is shaping up to be a source of conflict. More than $700 million  is expected to be generated from the passage of the land-conservation plan, Amendment One. However the state’s main land-buying program, Florida Forever—is set to get its budget slashed more than 80 percent in the Senate’s budget proposal--Something backers of Amendment One say sis wrong.