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Florida Medicaid expansion passes Senate, faces dead end in House


Despite facing a political brick wall in the state House, the Senate approved its privatized form of Medicaid expansion Wednesday, arguing that health coverage for uninsured Floridians is vital both to hospital financing and the state’s economy.

But short of reaching what several senators termed a “grand bargain,” the House today is poised to kill the Florida Health Insurance Exchange, which House Speaker Steve Crisafulli and Gov. Rick Scott condemn as an “expansion of Obamacare.”

The Senate approved the measure on an overwhelming vote of 33-3, but Senate President Andy Gardiner said that after today’s expected formal rejection by House members, lawmakers are ready to pivot quickly toward crafting a budget for the year beginning July 1. Work on crafting the new spending plan is expected to begin this weekend.

“At the end of the day, we have to do a budget,” said Gardiner, R-Orlando. “It’s not about personalities, it’s not about lawsuits, it’s not about threats. It’s not even our money, it’s taxpayers’ money. We’ll get our job done.”

The Senate vote came on the third day of a scheduled three-week special session. Daily costs to taxpayers will likely range between almost $24,000 to $87,000, according to historical data.

The special session became necessary after the two-month regular session ended May 1 with lawmakers angry and deadlocked over FHIX, with work scrapped on finalizing a state budget, the only bill lawmakers must approve each year.

Although Scott and the House’s opposition to FHIX only hardened in the weeks leading to the special session, senators rallied one last time Wednesday around the measure.

In speech after speech on the floor, senators touted the benefits of FHIX and what they called the failure of the House to compromise.

“We are working very hard to get to ‘yes,’” said Sen. Eleanor Sobel, D-Hollywood, who pleaded with House members to “keep an open mind.”

Sen. Don Gaetz, R-Niceville, pointed out that his own family was split – with his son, Rep. Matt Gaetz, R-Fort Walton Beach, an outspoken critic of the FHIX plan.

But the senior Gaetz insisted the Senate was right.

He accused Scott and House leaders of being inconsistent. They blistered the Obama administration for cutting federal aid to Florida hospitals, but then blasted FHIX’s reliance on drawing federal money for covering low-income, uninsured Floridians, Gaetz said.

“For those opposed to taking federal money, that train left the station long ago,” Gaetz said.

Senate Rules Chairman David Simmons, R-Altamonte Springs, called opponents “very inconsistent and illogical” in their approach to federal dollars.

The FHIX plan approved Wednesday is what Gardiner called a 2.0 version of the proposal lawmakers battled over through the regular session.

The measure originally was aimed at drawing $2.8 billion in federal funding to provide health coverage to 800,000 Floridians. Those eligible would be required to pay a modest premium and be employed, looking for a job or in school.

Tougher standards added by the Senate before the special session to blunt House criticism reduced both the amount of federal aid and the potential pool of eligible Floridians to around 500,000 people.

More provisions added this week even allowed Florida to repeal the law if federal funding levels changed.

But it clearly remains a no sale.

“The governor still opposes the bill,” said Jackie Schutz, a Scott spokeswoman, moments before the Senate vote.

Rep. Gaetz, shortly after hearing his father’s floor speech, tweeted, “I occasionally borrow Senator Gaetz’s neckties. I wish he would occasionally borrow my conservative principles.”

Although the House is expected to vote down the Senate’s health insurance expansion plan, hospital finances are certain to play a central part in the ensuing budget negotiations.

The Senate president, a hospital vice-president, spearheaded the push for FHIX, in part, to help hospitals offset a reduction of a $2.2 billion low income pool (LIP) that steers mostly federal money to health providers treating indigent patients.

LIP money is expected to be held to $1 billion this year. Hospitals say that will force them to reduce services or, in some cases, shutter completely.

Based largely on the premise that FHIX would draw Obamacare funding, the Senate budget proposals approved during the regular session was a stunning $4.2 billion greater than the House plan, but that difference would be erased by FHIX’s expected defeat.

In a first overture toward a budget deal, a House committee Tuesday reduced its proposed $690 million package of tax cuts by about $400 million to make state dollars available to help replace some of the LIP money expected to be lost by hospitals.

Senate Budget Chairman Tom Lee, R-Brandon, said Wednesday that he wasn’t sure that would be enough.

He warned that with tax cuts and increased school money remaining a priority for Scott, the House and many in the Senate, coming up with a spending plan to replace the $77 billion budget that expires June 30 may demand some reduced expectations elsewhere, including many hometown projects.

“There’s going to be a pruning,” Lee said.



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