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Feds To Florida On LIP, Medicaid: 'We're Watching You'

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The House and Senate remain at odds over whether to use federal Medicaid dollars to insure up to a million Floridians. A key feature of the dispute is a separate federal program reimbursing hospitals that treat low-income patients. Now the federal government is weighing in.

Update 8:11 p.m. House Speaker Steve Crisafulli's response to CMS's letter:

  The letter from CMS contains, at best, mixed messages about the federal government’s intentions on LIP funding. It is unthinkable that they would leave our state on the hook for over a billion dollars simply because they want a specific policy outcome.   We believe the Florida Senate has provided inaccurate and false hope to Washington, D.C., and has muddled negotiations.  Let me be clear - the discussions about LIP and Medicaid expansion must be separate. The fact is, Medicaid expansion will not cover all of the Floridians that need LIP funds.   We have long warned Floridians that the federal government is capable of holding states hostage based on untenable strings attached to federal funding. Nothing should give our state more pause than what has occurred today.   We call upon those who truly care about creating a safety net for the neediest Floridians to join us in asking the federal government to fulfill their commitment to Florida by providing continued LIP funding in a new form.           

Update 6:20 p.m.: Senate President Andy Gardiner issued this response to CMS' letter.

"The bottom line is: more than ever, today’s correspondence from CMS highlights the link between LIP and expansion and the need to consider a comprehensive Florida solution. Time is of the essence. The Senate remains open to meeting at any time to discuss our free-market approach to expansion or any alternative the House or Governor would like to propose."

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In a letter issued Tuesday to the Florida Agency For Healthcare Administration, the Federal Centers for Medicaid and Medicare Services says the future of the Low-Income Pool, and Medicaid expansion are linked. And the government says it’s closely monitoring talks in the legislature on whether to go forward with a Senate plan that uses federal Medicaid dollars to steer up to a million uninsured Floridians into private health plans.

The letter sent to the state, was forwarded to reporters by Senator Bill Nelsons office. The federal government says when it comes to the low-income pool, any future funding shouldn’t cover costs that would otherwise be covered through a Medicaid expansion. It also says provider payments need to be increased.

The state and federal government are an impasse over LIP funding, with Governor Rick Scott saying he isn’t inclined to support a Medicaid expansion, if the federal government doesn’t renew the Low Income pool program at its current funding levels.

The disagreements over Medicaid expansion and the LIP program have brought the state budget process to a stand-still.