Special session seems imminent as Medicaid fight continues

TALLAHASSEE, Fla. (AP) – Florida House leaders met behind closed doors Tuesday while Senate leaders held a special hearing in a last-ditch attempt to agree on Medicaid and finalize a budget as the need for a special session seemed imminent.

Impassioned senators, including many Republicans, tried to put aside politics and put a human face on the bickering between the House, Senate, Gov. Rick Scott and the Obama administration over Medicaid expansion and funds for hospitals that serve low-income patients.

“The people that we’re trying to take care of under the (Senate proposal) are people who are actually working,” said Republican Sen. Rene Garcia. They are individuals “that we are denying access to primary care because of politics, because of political dogma and that is just wrong.”

Florida has known for well over a year that federal funds for hospitals would end June 30. That’s because the Obama administration is transitioning to a system that uses taxpayer money to help individuals buy health insurance instead of reimbursing hospitals for caring for them.

The Republican-led Senate proposed a plan that would ultimately take federal money to allow Medicaid-eligible recipients to purchase private health insurance, while paying a small monthly premium. But Scott and House Republicans remain staunchly opposed. That’s put them in a lengthy showdown with the federal government, which insists Medicaid expansion must be part of the solution.

The disagreement came to a head last week when Scott compared the Obama administration to the mobster Sopranos and announced plans to sue them. He said they were holding the hospital funds hostage because the state won’t expand Medicaid.

The fight has stalled the Legislative session, where House and Senate budgets are $4 billion apart and are unlikely to be reconciled before session ends May 1. Republican Senate leaders conceded Tuesday that they might not pass a state budget until June, just before the end of Florida’s fiscal year.

Florida recently submitted its formal proposal to the feds and is still required to have 30 days of public input.

“Despite the best efforts of the Senate to develop a Florida-based solution, at this time there is no scenario under which we can complete a budget process that is open and transparent by May 1st,” Senate President Andy Gardiner said.

Senate Budget Chief Tom Lee said he met with Scott on Monday. Lee contended the governor was open to “compromises” but refused to go into details. But he did not directly ask whether Scott would veto a budget that used state money to replace federal hospital funding, or if it included Medicaid expansion. Lee said the door was “cracked open,” but conceded it’s problematic for Republicans to find a deal that doesn’t violate their “principles” regarding President Barack Obama’s health care overhaul.

“This is a very real problem, not just for the completion of our session, but for the image of the Republican Party in America,” said Lee. “And I do not think that the House or the governor wants this blood on their hands when this cart goes into the ditch.”

Meanwhile during a closed-door meeting, the House Majority Office presented GOP legislators with arguments why they should remain opposed to Medicaid expansion and cited a study that maintains that Medicaid coverage does not improve health care.

The presentation also cited the tangled negotiations between Florida and the Obama administration as another reason to oppose expansion.

House Speaker Steve Crisafulli during the meeting also urged members to “trust us” and hold to the House opposition toward expansion.

Meanwhile, state economist Amy Baker told senators their proposal would save Florida $1.2 billion over five years.

The federal government has offered to pay 100 percent of Medicaid expansion for the first few years and 90 percent after that. Baker called the Senate proposal a ‘self-supporting system’ that would generate enough money to pay the state’s cost of expanding Medicaid and a bit of a surplus.

Russ Armistead, CEO of Shands Jacksonville, called the fight a “human tragedy.” His hospitals stand to lose $95 million.

“If I lose it, I’ll close in a few months,” Armistead told senators, noting his organization is the seventh largest employer in Jacksonville.