Paying for the poor’s healthcare? Get it done

Without LIP money, Jackson Health System might have to shift costs of healthcare for the uninsured.
Without LIP money, Jackson Health System might have to shift costs of healthcare for the uninsured. hgabino@elnuevoherald.com

State legislators are gathering again in Tallahassee — so no one is safe. Floridians should pay attention to lawmakers’ agenda as the upcoming session takes shape.

Atop the list, just as it was during the last session, is how to fund healthcare for Florida’s 1 million uninsured and poor patients currently covered by federal dollars that the Obama administration is going to eliminate.

Here’s a refresher: The state’s so-called Low Income Pool (LIP) this fiscal year had $1 billion, of which $200 million went to Miami-Dade’s Jackson Health System and $180 million went to Broward Health. Florida’s LIP money is expected to drop to $608 million next fiscal year.

Filling the gap from the state budget, once again, will be a prickly challenge for lawmakers already strongly divided on the issue. Last year, lawmakers set aside general revenue to offset the cuts and help hospitals that care for large numbers of low-income and uninsured patients, like Jackson.

Senate President Andy Gardiner, R-Orlando, said lawmakers will have to decide during the upcoming session whether to use state tax dollars to help deal with the federal cuts. Mr. Gardiner was speaking to reporters and editors from across the state who gathered Wednesday at the Capitol for an annual Associated Press event, which signals the start of legislative wheeling and dealing.

Of course, none of this would be necessary if Florida Gov. Rick Scott pushed for Medicaid expansion, which the feds view as a substitute for LIP funds.

Last session, the battle over how to fund medical care for the needy grew so heated the Republican-controlled House and Senate stopped talking, and House members, opposed to Medicaid expansion or paying for LIP, walked out early.

At least they’ve been consistent — consistently wrong.

Gov. Scott refused to consider accepting $51 billion in federal funds to broaden the program’s umbrella. In 2013, he broke with party members to support the initiative, but did absolutely nothing to make it happen. Now, he’s not even paying lip service — no pun intended — to expanding Medicaid.

The governor, without little evidence, fears the federal government will eventually stick the state with the expansion costs. He sued the federal government for forcing the state to accept it. The lawsuit was dropped, but the governor won one particular battle when the feds blinked and backed down from their threat to cut LIP money completely. They agreed to approve funding, but also a phase-out.

Now, public hospitals in the state are again on pins and needles over funding — and JMH, for one, says it can’t provide the same patient service for the uninsured without its allocation.

“It’s important for our state and federal leaders to understand that large short-term cuts would short-circuit our progress and limit our ability to honor our mission and serve our community,” the hospital said in a statement to the Editorial Board.

Translation: If the working poor are left without coverage, hospitals will have to shift the cost of treating the uninsured to the insured.

There is some state money available: Florida is projected to have at least $635 million more in tax revenue next year. Gov. Scott is saddled by a reelection campaign promise to cut taxes by $1 billion. He wanted $673 million in cuts in this year’s budget; lawmakers agreed to $427 million. Could some of this money be redirected to LIP?

South Florida taxpayers shouldn’t have to help foot the bill when there are solid alternatives. It’s still early. Lawmakers should come up with a reasonable and responsible solution to the LIP dilemma — starting now.