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Florida House Quits Early Over Medicaid Expansion Disagreement

April 27, 2015 - 6:00pm

Sine die came three days early for the Florida House as the Legislature looked no closer on Tuesday to reaching an agreement over whether the state should expand Medicaid.

"At this time, we are at an unfortunate impasse," House Speaker Steve Crisafulli, R-Merritt Island, wrote in a letter to the Florida Senate. "Its our understanding from the Senate responses that you would prefer to wait on allocation decisions until the House expands Medicaid, or until CMS provides us with sufficient funds in response to our LIP waiver request."

The original adjournment was scheduled for Friday.

On Monday, Senate President Andy Gardiner penned a letter to Justin Senior, deputy secretary for Medicaid, that the federal government needed to make some sort of arrangement for LIP funds.

We are concerned that with no suggestion of expanded coverage, such as the one recommended by the Florida Senate, the state may not be successful in gaining authority to spend $2.2 billion in LIP payments. Without additional coverage, your LIP model may not be construed as a first step in a transition plan, he wrote. As you know, the Legislature is responsible for constructing a balanced budget that meets Floridians need for education, public safety, environmental protection, and other important governmental functions, as well as health care. Failure to use available federal resources for expanding coverage will create negative fiscal and economic consequences for the state that are simply unnecessary.

The House and Senate have been going back and forth for weeks over budget differences which primarily center on the expansion of Medicaid in Florida.

Disagreements over the budget grew fiercer as the 2015 regular session began to wind down, with some of the state's most powerful lawmakers making it incredibly clear they had no intentions of changing their stance on the expansion.

We will stand and fight with the working poor against the special interests and big corporate hospitals every day of the week! wrote Speaker-designate Richard Corcoran, R-Land O'Lakes, this week.

Earlier this month, the federal government announced it would not be renewing the Low-Income Pool program funding, withholding nearly $1 billion in funding for the program which helps hospitals serve poor patients statewide.

The Scott administration and the House are strongly against using federal dollars to expand what they believe is a flawed Medicaid system. The Houses proposed $76.1 billion budget doesnt include the federal governments match for LIP dollars.

The Senate, however, supports the expansion. Under that chamber's plan,the state would create a health-insurance exchange where people with an income of up to 138 percent of the federal poverty level can go to choose from among a number of private insurance plans.

The estimated 800,000 eligible are people who do not qualify for Medicaid right now.
Crisafulli said the House was ready to work with the Senate to "mitigate negative impact" on Florida should the federal government fail to renew the LIP funding, which is set to expire at the end of June.

An early ending for the Florida House means the Legislature will be forced to enter into a special session to agree on a state budget. When that session will take place, however, is uncertain.

"The House and Senate have come together on significant policy issues this session and I am confident we will be able to return and finish our constitutional duty to pass a balanced budget," wrote Crisafulli.

Democrats saw the move as an embarrassment for the GOP.

"The House GOP was so unwilling to even discuss expanding access to health care, they have now abandoned priorities essential to all Floridians, from environmental protections to expanding the right to vote and helping kids with special needs," wrote Florida Democratic Party chair Allison Tant. "Republicans would give themselves a vacation after denying 800,000 working Floridians access to health care. Floridians deserve better."

Reach Tampa-based reporter Allison Nielsen by email at or follow her on Twitter: @AllisonNielsen

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