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Health News Florida

‘Bumped’ Budget Issues Include LIP

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Dozens of budget issues --- including the one that threw lawmakers into a special session to finish work on the state budget --- moved up the legislative ladder Tuesday, starting the next round of talks aimed at resolving differences between the House and Senate spending plans.

One of the largest issues "bumped" from lower-level negotiators to the House and Senate budget chiefs was how to structure payments from the state's Low Income Pool program to hospitals and other health-care providers that care for large numbers of low-income patients. A dispute over the so-called "LIP" program --- as well as a plan to provide insurance coverage to poor Floridians --- helped derail the regular session this spring.

The issue will now be handled by Senate Appropriations Chairman Tom Lee, R-Brandon, and House Appropriations Chairman Richard Corcoran, R-Land O' Lakes, in the next phase of budget negotiations, which are set to begin Wednesday. If Lee and Corcoran can't agree, the issues will be directly negotiated by Senate President Andy Gardiner, an Orlando Republican and hospital executive, and House Speaker Steve Crisafulli, R-Merritt Island.

"We just ran out of time, to be honest with you," said Senate Health and Human Services Appropriations Chairman Rene Garcia, a Hialeah Republican who led Senate negotiators on the health-care budget.

Lawmakers are trying to come up with a model for LIP that will soften the blow from the federal government's decision to reduce the program from nearly $2.2 billion in the current budget year, which ends June 30, to $1 billion next year. Lawmakers are also pouring $400 million in state tax dollars into an increase in Medicaid reimbursements for hospitals --- drawing down almost $610.9 million in federal matching money --- to offset the loss.

"I'd much rather make sure that it's right than to rush through it and to be worried about a deadline for what time we need to bump or any of those kinds of things," said House Health Care Appropriations Chairman Matt Hudson, a Naples Republican and the lead House negotiator. "We pushed it and we got an awful lot of agreement, and we're very close. But taking another day to make sure that we're appropriately handling in excess of a billion dollars, I think, is appropriate."

The Legislature is racing a June 30 deadline to get a budget agreement or face the prospect of a government shutdown.

Meanwhile, the federal government asked a judge Tuesday to reject Gov. Rick Scott's request for court-ordered mediation in a lawsuit about health-care funding. Scott filed the lawsuit this spring arguing that the Obama administration was trying to unconstitutionally link continuation of the Low Income Pool program with expansion of Medicaid.

The lawsuit has continued after the federal agency that oversees Medicaid told state officials they can tentatively expect $1 billion in state and local funds next year for LIP, followed by $600 million the year after that.

"There is no basis for mediation as to the core issue alleged in plaintiffs' (the state's) complaint because the secretary (of the U.S. Department of Health and Human Services) has already stated definitively that she will not deny a LIP extension based on the state's failure to expand its Medicaid program and has already preliminarily concluded that a LIP can be approved for the next two years,'' the filing said.

Scott's office responded Tuesday by blasting the federal government.

"Sadly, the Obama administration continues to delay any final agreement on funding for the Low Income Pool," Scott spokeswoman Jackie Schutz said in a statement. "The state is continuing to request this issue be immediately resolved by any means possible."

Lawmakers have been moving ahead with the $1 billion number and seem content to do so while letting the lawsuit play out.

"I've focused entirely on our process," Hudson said. "What might be going on in the courts and what-not, I don't want to even ponder, frankly, when the outcome of that may or may not be relative to our special session timeframe."

Other budget issues were "bumped" across the board Tuesday. Many of them are projects and other spending items sought by lawmakers for local constituencies back home.

But there were some agreements reached Tuesday. The House and Senate struck a deal to modify the performance funding system for state universities. The Senate had wanted to plow $200 million of state money into the system while having universities put $200 million of their current budget at risk; instead, the state will pay $150 million while universities contribute $250 million to the plan.

The Senate also dropped a demand to use a budget-related bill to place limits on new four-year degrees at state colleges in exchange for other concessions from the House. But several other pieces of education policy, including broader eligibility for personal learning scholarship accounts for students with disabilities, remain unresolved.

Negotiators, though, focused primarily on a 3 percent increase in per-student funding for education. While the new number is short of a record on a per-pupil basis, the total amount of funding sent to schools will be the largest ever. Sen. Don Gaetz, who oversees his chamber's education budget, said some had seen that as unlikely given the state's budget situation.

"And in fact, I think we can turn in a report showing that education in many cases in many ways will have its best year in Florida history," said Gaetz, R-Niceville.

 

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