State Politics

Without bills to vote on, state lawmakers attend public hearing on hospital funding

As lawmakers continued to quarrel over the abrupt end of the legislative session, state healthcare officials on Friday held the last of three public hearings on the hospital funding program at the center of the stalemate.

The public hearings are required before the federal government can approve or deny Florida’s petition to extend the so-called Low Income Pool program. The LIP program uses $2.2 billion in federal and state money to reimburse hospitals like Jackson Health System and Tampa General that treat large numbers of uninsured and Medicaid patients.

In attendance Friday were several House Democrats, who stayed in Tallahassee despite Republican House Speaker Steve Crisafulli’s unexpected decision to adjourn earlier in the week.

Rep. Mia Jones, D-Jacksonville, spoke on behalf of the group, stressing that the continuation of the LIP was necessary.

But Jones said LIP alone would not be enough.

“We know that implementing any form of LIP on its own will only be a Band-Aid, and we know a Band-Aid is not to going to sustain us as a state long term,” she said, urging the state Agency for Health Care Administration to add Medicaid expansion to the proposal.

Earlier in the week, Florida Medicaid Director Justin Senior held public hearings in Orlando and Miami. Both were lightly attended, but broadcast on public television.

“It’s like Downton Abbey, only my show is not entertaining at all,” he joked.

The final installment drew roughly three dozen attendees, including top healthcare officials and lobbyists who would have been at the Capitol had the session still been going on.

Senior opened the meeting by describing Florida’s proposed successor to LIP. He said the plan — developed by the Florida Senate — addressed federal concerns about Florida’s old program by distributing the funds more broadly, instead of targeting a few key hospitals.

Senior said the revamped model would not pay for people who would be eligible for health insurance under Medicaid expansion.

“We’re trying to make sure those two issues are separate,” he said. 

His boss, Republican Gov. Rick Scott, does not support using federal dollars to expand Medicaid and has insisted on keeping the two issues separate.

Most of the public testimony Friday was in support of the LIP proposal.

Tony Carvalho, president of the Safety Net Hospital Alliance of Florida, said the end of the LIP program without a replacement would be “catastrophic” for his member hospitals.

The children’s hospitals alone, Carvalho said, would shoulder $354 million in cuts.

After the meeting, Senior said there had been no recent talks with the U.S. Centers for Medicare and Medicaid Services about the future of LIP.

“We’re hopeful that we can have discussions with them next week,” Senior said, adding that the agency approved a continuation last year without a formal process.

The LIP program is at the center of the bitter and increasingly nasty battle between the House and Senate. The two chambers have vastly different perspectives on handling the potential budget hole.

The Senate wants to use $2.8 billion in federal Medicaid expansion dollars to expand private healthcare coverage to more than 800,000 low-income Floridians, saying it would help safety-net hospitals on the front end. But the more conservative House considers that plan too costly, and is concerned the federal government would back out of its commitment to provide funding. The House also refuses to support anything associated with Obamacare.

Lawmakers will have to return to Tallahassee this month or next to complete the budget. The deadline is June 30.

Contact Kathleen McGrory at