Florida governor says concession in ObamaCare dispute was ignored

Florida Gov. Rick Scott (R) argues in a newly filed complaint in his lawsuit against the Obama administration that he made a key concession to the federal government that was disregarded. 

{mosads}Scott announced earlier this month that he was suing the administration over what he calls an effort to force his state to expand Medicaid, by linking it to the renewal of separate federal funds to cover uncompensated care at hospitals, known as the Low-Income Pool (LIP).

The administration argues that it is a better system to give people coverage in the first place through a Medicaid expansion rather than reimbursing hospitals for covering uninsured people through LIP.  

But the complaint filed in the case argues that Florida actually agreed to the administration’s requirement that the LIP money not be used for costs that would otherwise be covered by expanding Medicaid, but that the administration’s Centers for Medicare and Medicaid Services (CMS) disregarded that concession in a letter it then sent to the state laying out its terms. 

“The CMS letter also asserted that ‘uncompensated care pool funding should not pay for costs that would be covered in a Medicaid expansion,’ yet made no mention of the fact that the State had unequivocally expressed its willingness to tailor the size of its LIP program to eliminate that potential overlap,” the complaint states. 

CMS said it is not aware that Florida has made such a proposal as part of its previous submissions, and pointed to its LIP application, which is essentially the same level as last year.

The agency issued a general statement that Florida is free to expand Medicaid or not, and that “CMS will review proposals regarding uncompensated care pools based on the same principles whether or not a state has expanded Medicaid.”

CMS also notes that it has not rejected any proposals from Florida. Florida did not submit its application for LIP funding until April 20, and it is now in a public comment period before heading to CMS for review. 

CMS has also contacted Texas, Tennessee, California, Massachusetts, Arizona, Hawaii, Kansas and New Mexico to communicate the message that uncompensated care funding should not be used for costs that would be covered under Medicaid expansion. 

Texas Gov. Greg Abbott (R) agrees with Scott that this constitutes a hardball tactic of trying to force Medicaid expansion by threatening the separate funds. Abbott has backed the Florida lawsuit.

The Florida dispute comes as the state government is in an intense battle over whether or not to expand Medicaid. The Republican-controlled Florida House is against it. The Senate, also controlled by Republicans, is for it. The chambers must agree on a budget, but the House on Tuesday left town before Friday’s scheduled end of the session, raising the prospect of the need for a special session. 

The state Senate President, Andy Gardiner (R), has been critical of Scott for suing and for waiting so long to submit the LIP application. He points out that Florida has known for a year that LIP was expiring on June 30.

“While everybody’s pointing fingers at CMS and suing everybody we knew this was going to happen a year go,” Gardiner told The Hill in an interview last week. 

Gardiner, as well as CMS, point out that LIP was a temporary program that CMS is under no obligation to continue. 

“It’s an intriguing situation to demand money for a voluntary program that nobody has to participate in,” Gardiner said.

This post was updated to reflect new information.