FHIXating On The Special Session
After weeks -- and in some ways, months -- of discussion, the special legislative session to determine what to do with the budget starts Monday. Which meant everyone spent the last week getting ready for it.
The Senate was gearing up to make a last-ditch pitch for something that uses Medicaid expansion funding to give more people health care but should definitely not be called Medicaid expansion. Environmentalists planned to push once again for more money to buy land after voters passed a constitutional amendment in November aimed at conserving land and water.
But preparations were not limited to the special session. Patients needing non-euphoric medical marijuana could finally start getting ready to enjoy the benefits after a judge cleared the way for regulations governing the new industry to take effect. And it could soon be time to batten down the hatches, with hurricane season starting Monday.
We will leave it to the reader to decide whether the legislative session and hurricane season beginning on the same day is coincidence or omen.
FHIX, TAKE TWO
It's not quite right to say that the Senate's proposed Florida Health Insurance Affordability Exchange --- or FHIX --- has gone over like a lead balloon with Gov. Rick Scott and House Republicans. No one has ever declared "war" on a lead balloon, as House Appropriations Chairman Richard Corcoran, R-Land O' Lakes, famously did with regard to FHIX.
But the Senate tried Tuesday to come up with something that everyone might like better. It didn't work.
Under the new version of the proposal, the Senate would skip an interim period in which the state would put people in Medicaid managed-care plans, a change aimed at addressing House criticism that FHIX is simply an expansion of oft-criticized Medicaid. The interim period was originally designed to provide coverage while the state waited to hear whether the federal government would approve using Medicaid-expansion funding to help lower-income Floridians purchase private health insurance.
The FHIX plan, which includes a work requirement for recipients, would depend on the state getting what is known as a waiver from the U.S. Department of Health and Human Services. The new Senate bill would also require any "significant changes" to the waiver by federal officials to be approved by the Legislature before the plan takes effect.
"There's no agreement on any of this," said Senate President Andy Gardiner, R-Orlando. "I think what we're just trying to show here in the Senate is that we're willing to have an open mind and put forward different ideas and suggestions, and then we'll see what happens next week."
Saying there was no agreement was something of an understatement.
"A budget that keeps Florida's economy growing will cut taxes and give Floridians back more of the money they earn, not inevitably raise taxes in order to implement Obamacare and grow government," Scott said in a statement issued by his office.
House Speaker Steve Crisafulli, R-Merritt Island, also slammed the proposal. He reiterated a common House talking point: The work requirements that are part of the Senate plan and give it a more conservative sheen are unlikely to be approved by federal officials.
"When you remove the Senate's 'conservative guardrails' that the Obama administration fundamentally opposes, all you are left with is a costly and inefficient entitlement program to serve able-bodied working age adults with no children," Crisafulli said.
Meanwhile, the Scott administration seemed to offer its own solution to the problem, picking up on space provided by the federal Centers for Medicare & Medicaid Services, which is part of the Department of Health and Human Services.
In a letter last week saying the state could expect $1 billion in LIP funding, federal officials suggested the state could also use leftover local dollars that have flowed into the LIP program as matching funds to draw down other Medicaid money. Those dollars would not be a part of LIP, but could help close the shortfall.
"Thank you again for all of your assistance and work to keep Florida's Medicaid program whole," wrote Justin Senior, the state's Medicaid director. "Your guidance has been essential to ensuring that there is no major fiscal impact to Florida health-care providers who support the needs of low-income families in our state."
Gardiner, though, said in a statement issued by his office that that approach would be "shortsighted," in part because LIP is scheduled to fall again in the 2016-17 budget year. And by the end of the week, the federal government was tamping down expectations for quick approval of that notion.
The House put its own ideas for special session health-care legislation on the table. They were different than what the Senate has in mind.
House Republicans filed six bills Wednesday that delve into hot-button issues such as getting rid of a regulatory process for new or expanded hospitals and allowing advanced-registered nurse practitioners and physician assistants to prescribe controlled substances.
The proposals are not new, with House GOP leaders also pursuing many of the ideas during this spring's regular legislative session. The bills will again draw heavy lobbying, as they did then.
WE'VE GOT SOME LAND IN THE EVERGLADES TO SELL YOU
Environmentalists, meanwhile, continued to express optimism that they can get money from Florida lawmakers for a reservoir in the Everglades during the upcoming special legislative session, something they couldn't do during the 60-day regular session.
Along with health care, education funding and tax cuts, how to deal with land and water conservation funding in the wake of the new constitutional amendment approved by voters is likely to be one of the major issues in the special session.
Members of the Everglades Trust, the Everglades Foundation and Florida Audubon said Wednesday they will approach the special session with a goal of securing money to build a 40,000-acre to 60,000-acre reservoir south of Lake Okeechobee. They also will seek written directions from lawmakers that the South Florida Water Management District find the needed acres and establish a timeline to build the reservoir.
"We cannot and we will not give up on the goal of buying land for a reservoir south of Lake Okeechobee," Audubon Executive Director Eric Draper said during a news conference Wednesday.
Environmentalists are seeking to divert polluted water being sent into estuaries east and west of the lake. But the special session comes after the water management district's Governing Board voted May 14 to terminate an expiring option to purchase 46,800 acres in the Everglades from U.S. Sugar Corp.
Draper said funding efforts during the regular session failed because proponents were focused on completing the U.S. Sugar deal.
"I think with that off the table we have a new situation, and we even have some indications that people from the business side of things, from the sugar farmers, are open to the idea that something more needs to be done in the Everglades Agricultural Area," Draper said.
The U.S. Sugar land was estimated to cost as much as $500 million, a price tag that far exceeded the proposed spending levels lawmakers put forward in the regular session for land acquisition under the voter-approved initiative known as Amendment 1. That initiative requires the state to set aside increased amounts of money for land and water management and acquisition.
Land buying wasn't a priority for Republican legislative leaders during the regular session. The House proposed selling $205 million in bonds for the Florida Forever program, with about half of the money going toward water resources, the state's natural springs, Kissimmee River restoration, and ranchland preservation.
The Senate offered $37 million for land acquisition, which included Kissimmee River restoration and springs preservation.
'WAITING FOR SOMETHING TO HATCH'
After months and months of regulatory gridlock, patients could have access to long-awaited, non-euphoric pot products by the end of the year. A judge on Wednesday rejected a challenge to a proposed rule setting up the medical marijuana industry in Florida.
Department of Health officials could begin processing applications for the low-THC cannabis within 41 days of Wednesday's decision by Administrative Law Judge W. David Watkins, according to an agency spokeswoman.
Watkins pointedly began his 68-page ruling with an excerpt from "Charlotte's Web," by E.B. White.
"Life is always a rich and steady time when you are waiting for something to happen or hatch," Watkins quoted from the children's book.
The name "Charlotte's Web," a type of cannabis cultivated in Colorado, has become nearly synonymous with marijuana that is low in euphoria-inducing tetrahydrocannabinol, or THC, and high in cannabadiol, or CBD.
Parents of children with a severe form of epilepsy pushed the Legislature last year to approve the low-THC cannabis, believing it can end or dramatically reduce life-threatening seizures.
But their joy over the passage the law, and Scott's support of it, ceded to frustration as delays --- including Watkins' November invalidation of health officials' initial attempt at a rule --- kept pot operators from getting started. Regulations for the industry were supposed to go into effect Jan. 1.
On Wednesday, the administrative law judge rejected all of the objections in a challenge filed by Baywood Nurseries, which contended, among other things, that the rule was tilted in favor of large nurseries.
"I am thrilled. I am one happy legislator," said Rep. Matt Gaetz, a Fort Walton Beach Republican who was instrumental in the law's passage last year. "My only hope moving forward is that we don't see more special-interest litigation when licenses are awarded."