The Obama administration is ratcheting up pressure against Florida to expand Medicaid through President Obama’s healthcare law — and now Gov. Rick Scott, a Republican, said he will sue the federal government in response.
Though Scott had backed the Medicaid expansion in the past, his efforts were thwarted by the state legislature, and he has since come out opposed to it. Currently, the more conservative Florida House is blocking efforts to expand the program, while the Senate has backed a version of the expansion.
Florida is one of the largest states that has yet to expand Medicaid through Obamacare, and it remains a big prize for the administration. The latest tool being employed by the Obama administration’s Centers for Medicare and Medicaid Services against the state is a program that gives money to hospitals and other healthcare providers who give care to the uninsured.
Florida’s Low Income Pool, or LIP, started in 2006 as a way to make sure the providers received some sort of payment for services that would otherwise go uncompensated. Funding for the $2 billion program is set to expire in June unless the federal government extends it.
CMS has decided to use the LIP funding issue as a cudgel to get Florida to embrace the Medicaid expansion, the argument being that if Florida accepted the new Medicaid funding, the LIP program wouldn’t be as necessary.
“When the Affordable Care Act (ACA) was enacted, it established a more comprehensive approach to providing health care coverage, including Medicaid, while supporting hospitals that serve communities with the greatest needs,” CMS wrote in a Tuesday letter to Florida’s Deputy Secretary for Medicaid, Justin Senior. “Medicaid expansion would reduce uncompensated care in the state, and therefore have an impact on the LIP, which is why the state’s expansion status is an important consideration in our approach regarding extending the LIP beyond June.”
A copy of the letter was obtained from CMS and is posted in full below.
In response to an email inquiry from the Washington Examiner, a CMS spokesman wrote, “we articulated to the state that we believe the future of LIP, sufficient provider rates, and Medicaid expansion are all linked in considering a solution for Florida.”
On Thursday, Scott announced he was taking legal action against the Obama administration.
“It is appalling that President Obama would cut off federal healthcare dollars to Florida in an effort to force our state further into Obamacare,” Scott said in a released statement.
Florida led the lawsuit against the administration that prompted the Supreme Court in 2012 to give states a choice on whether or not to expand Medicaid. As Obamacare was originally written, states that didn’t expand Medicaid would lose all of their existing funding for the program, which would be a massive financial hit that no states could reasonably bear. The Supreme Court ruled that it was unconstitutionally coercive to condition funding for the old program on acceptance of the newly expanded program.
Scott, in announcing the decision, said linking LIP funding to the Medicaid expansion would “violate the law by crossing the line into a coercion tactic for Obamacare.”
