A contrite Legislature returned to the capital Monday with a series of concessions and the goal of quieting the bitter intra-party feud over health care that sent lawmakers into overtime.
The House, which left the regular session three days early, gaveled open the session as loudspeakers blared the Beatles tune Come Together, and then politely convened a workshop on the Senate proposal to create a privately run alternative to Medicaid expansion.
But leaders in both chambers acknowledged that, ovations aside, the House may not have the votes to approve the Senate’s Florida Health Insurance Exchange plan, or FHIX, which would create a privately run premium assistance program to provide health insurance coverage under Obamacare to as many as 385,000 uninsured Floridians.
As a result, the budget dispute has shifted to how much state money to use to offset the $1.2 billion loss in federal Low Income Pool funds to reimburse hospitals that provide charity care for the uninsured, and how much to set aside for tax cuts.
“The last time we gathered together, the House and the Senate were truly at a serious impasse,” said House Speaker Steve Crisafulli, R-Merritt Island, addressing his chamber for the first time since it adjourned five weeks ago in protest of the Senate’s push for Medicaid expansion as part of the budget talks.
He thanked Senate President Andy Gardiner, R-Orlando, and the Senate “for their willingness to separate these two issues” and said “because of his compromise I am confident that we will be able to complete our work.”
Gardiner called the Senate proposal “bout as conservative a plan as you’re going to get”and suggested that if it doesn’t pass this session “i’s not going to go away.”
“The health care debate will last long after I’m gone,” he told reporters after opening the session.
Crisafulli vowed to bring the Senate bill (SB 2a) to a floor vote in the House on Friday, but it is viewed by many an exercise in futility, as most of the House leadership oppose the measure and Gov. Rick Scott has all but vowed to veto the proposal.
All 39 House Democrats support expanding subsidized health insurance to the uninsured. That means 22 House Republicans would have to support the Senate plan for it to win a majority of votes in the House — an unlikely scenario.
“I don’t see any indication from the House they are willing to come up with a compromise,” said House Democratic Leader Mark Pafford of West Palm Beach.
Meanwhile, the House showed signs it was willing to compromise on tax cuts and education spending to help the Senate reach its goal of cushioning the blow to hospitals for the loss of federal LIP money, used to reimburse them to provide care to the insured and underinsured.
Scott proposed a plan last week that would slash state aid to public hospitals, and the biggest losers would be Jackson Memorial in Miami, Broward General Medical Center in Fort Lauderdale, Shands Hospital in Gainesville, Tampa General and All Children’s in St. Petersburg.
Those proposed reductions, totaling $214 million next year, are seen as a move by Scott to ensure passage of his top priority of nearly $700 million in tax cuts. But the federal Centers for Medicare and Medicaid Services warned that the governor’s plan may not meet the long-term goals of the agency and South Florida hospitals said they may not participate, jeopardizing the program.
During the regular session, the House had offered to use as much as $600 million in general revenue to help hospitals, but on Monday Crisafulli told the Herald/Times that the number is likely to be lower and the House wants to use the money to increase Medicaid reimbursement rates, not direct payments to hospitals.
To pay for the Medicaid increases, the House appears prepared to reduce its tax cut package from $690 million to close to $400 million, said Rep. Matt Gaetz, R-Fort Walton Beach, chairman of the House Finance and Tax Committee. The committee is scheduled to take up the tax-cut package on Tuesday.
“We’ve had to scale back some of those tax cuts, but I still think we’re going to pass a very meaningful reduction in taxes that will affect every Florida family,” Gaetz said.
That original $690 million plan included eliminating taxes on cell phones and cable TV, which could save households around $40 a year.
Throughout the day, legislators made an attempt to show that they were determined to move past the hard feelings and rancor that pitted Republican against Republican and led to the budget stalemate.
As the House Health & Human Services Committee dissected the Senate plan, Crisafulli and Senate Appropriations Committee chairman Richard Corcoran sat silently at the side of the room listening.
At the other side of the Capitol, the Senate Health Policy Committee unanimously passed its FHIX bill, which included several changes aimed at overcoming opposition by Scott and the House. For example, the bill now requires job seekers to register with the state employment portal, Career Source, and patients would no longer be required to enroll in Medicaid HMOs starting July 1.
The Senate plan also would offer coverage to low-income people who are “residents of this state,” which includes non-citizens who are in Florida legally, such as those who hold work visas. Florida has one of the largest immigrant populations of any state.
“This is a coverage opportunity for people who are in this country legally,” said Sen. Don Gaetz, R-Niceville, noting that it “doesn’t expand Medicaid one jot or tittle” because it requires anyone who wants coverage to either get a job, seek a job or get training for a job. “That’s come a long way from concerns from the other chamber and concerns we’ve heard from our governor.”
But Gaetz, who is chairman of the Senate Education Appropriations Subcommittee, acknowledged that the move toward concessions also meant that everyone, including the governor, was going to have to compromise. He said he doubted it was possible to give the governor all of the increase he sought in public school spending, or about $50 more per student than in the 2007-2008 year.
“There's no way that one particular group is going to come out of this special session covered in glory,” Gaetz told reporters. “Everybody is going to take a hit on their expectations.”
Scott visited an elementary school in Miami on Monday and called on the Legislature to carry out his other big campaign promise, to boost per-student funding to a record-high $7,176 per student for next year.
“We have the funds to do it. This is the special session. Now is the time to do it,” Scott said at Dr. Carlos J. Finlay Elementary School in southwest Miami-Dade.
The session is scheduled to end on June 20 at a cost to taxpayers of about $75,000 a day, or a maximum cost of $1.5 million, if legislative leaders approve members’ lodging and meals for all 20 days.
Eight legislators with scheduling conflicts were excused from the first day of the session.
They included two of Crisafulli’s top lieutenants: House Majority Leader Dana Young, R-Tampa, and House Rules Committee Chairman Ritch Workman, R-Melbourne, who had previously scheduled a cruise and said he would be “on international waters” through June 9.
Tampa Bay Times staff writer Michael Auslen and Miami Herald staff writer Christina Veiga contributed to this report. Contact Mary Ellen Klas at meklas@MiamiHerald.com or follow @MaryEllenKlas