In a last-ditch effort to end the budget stalemate, House Speaker Steve Crisafulli on Thursday offered to set aside $200 million in state money for the hospitals and county health departments that would be hurt by the end of a federal-state program known as the Low Income Pool.
It doesn’t back down from the House’s position, now 3 years old, to not expand Medicaid.
The House offer of extra money, which would come from reducing proposed tax cuts and spending on K-12 education, could be used to draw down an additional $305 million in federal funds, Crisafulli said, meaning about $505 million would help hospitals shoulder the cost of treating uninsured, under-insured and Medicaid patients.
Crisafulli conceded that the amount would be less than the $1.3 billion Florida hospitals had hoped to receive from the federal government.
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“It’s a conversation starter,” he said.
Senate spokeswoman Katie Betta said that Senate President Andy Gardiner hadn’t yet had time to review the proposal. But earlier in the week, Gardiner recommended dedicating as much as $600 million in state money in the absence of the LIP dollars.
The House and Senate have been struggling to build the state budget since February, when the U.S. Centers for Medicare and Medicaid Services announced it would not be renewing Florida’s LIP program “in its current form.” Although the program was scheduled to end June 30 under an existing agreement with the federal government, Republican Gov. Rick Scott and the House assumed Florida would get an extension.
State health officials have proposed a potential successor program, but have yet to hear back from CMS.
The silence is partly because CMS has said it wants Florida to expand Medicaid as a condition of LIP being renewed. The Senate is advancing a plan to accept $2.8 billion in federal Medicaid money to expand coverage to more than 800,000 low-income Floridians. But the House has refused to consider the proposal, leading to gridlock over the budget that will likely require a special or an extended session to resolve.
Crisafulli described his offer Thursday as a chance to move forward with the budget building process while Florida waits for an answer from the feds.
The House is assuming that Florida will receive some amount of LIP money, albeit a lesser amount than in previous years.
Crisafulli said he didn’t “think necessarily that hospitals should be held harmless” in the event the LIP funding shrinks.
“They built their budgets around a lottery,” he said. “Sometimes we have to restructure in business because revenues change.”
Of the $200 million on the table, about $90 million would be taken from the proposed budget for school construction and maintenance. Another $80 million would come from a proposed $690 million tax cut package, and the rest would come out of reserves.
It’s not clear whether Crisafuli’s proposal is too little, too late. After all, the session is supposed to end May 1.
Earlier in the day, Senate Budget Chairman Tom Lee, R-Brandon, suggested that lawmakers should “wait for a response to come back [from CMS] that opens a landing zone” before building the budget.
He said he was hoping to reopen informal talks with the federal government to get “some sort of signal” on the amount of money Florida was likely to receive.
House Minority Leader Mark Pafford, of West Palm Beach, who is not included in budget negotiations, questioned the sincerity of Crisafulli’s offer.
“I can't imagine it has merit, at this late hour, to jam something through that probably is half-baked when in fact we can draw down billions of dollars by accepting the Senate [expansion] plan,” Pafford said.
Herald/Times staff writer Mary Ellen Klas contributed to this story.
Contact Kathleen McGrory at kmcgrory@MiamiHerald.com.