From FAHU Lobbyist, Rhett O'doski

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From FAHU Lobbyist, Rhett O'Doski

Week 5 is almost in the books and Legislators will take Friday and Monday off for the Easter holiday. This past week, both chambers voted vastly differing budget plans out of their chambers setting the stage for high level budget battles after the Easter break. The largest differences are how the two chambers account for the almost two billion hole in the budget created by the looming expiration of the federal LIP funds. The State of Florida is currently undergoing a series of negotiations with CMS through the Agency for Health Care Administration and we learned this week that the Senate dispatched Senators Garcia and Richter to Washington on their own fact finding mission. Senator Garcia stated upon his return on Wednesday that he was encouraged by the discussions, however as described below the discussions were abruptly halted by CMS.

So far this year we have been successful in thwarting the advancement of legislation that would make step therapy protocols impossible to implement forcing drug costs up. Senate bill 784 by Senator Don Gaetz known as the “Right Medicine, Right Time” act has advanced through the Senate but the House bill, HB 863 by Representative Harrison has yet to receive a hearing and it is unlikely to at this point. Thank you to all FAHU members who reached out to your legislative contacts expressing opposition.

Insurance coverage mandates have reached similar fates in the House of Representatives this year. Senator Ring’s SB 142 which is an expansion of a current autism mandate has moved through one of four committees with the House version also without a hearing so far.

TALLAHASSEE – In the most adamant remarks yet from House leaders, Rep. Richard Corcoran, R-Land O’Lakes, said Thursday the chamber “won’t dance” with the Senate on Medicaid expansion.

“We’re not dancing this session, we’re not dancing next session, we’re not dancing this summer,” said Corcoran, the House’s top budget writer.

His remarks were part of staunch defense of the House position to refuse a Senate plan to offer Medicaid eligibility to 800,000 Floridians making up to 138 percent of the federal poverty level, or about $33,000 a year for a family of four.

The plan, pushed forcefully by Senate President Andy Gardiner, R-Orlando, who is also an executive with Orlando Health, requires newly eligible Medicaid recipients to be working or looking for work and pay co- pays and premiums to receive care.

But Corcoran called the Medicaid program a broken system providing sub-par care.

“I don’t care what they package what they send to us . . . when you open that present what you give to the people of this state is Medicaid. And Medicaid doesn’t work,” Corcoran said.

Corcoran, in line to become House Speaker in 2016, said his alternative private market plan offering health care to fewer uninsured Floridians never was heard in the Senate in 2013, while the House had an eight-hour debate on a Senate Medicaid expansion plan that year. House Republicans ultimately rejected it.

Senators head to Washington to discuss LIP

Amid a budget battle that has the House and Senate more than $4 billion apart in health care spending, Senate President Andy Gardiner, R-Orlando, sent Sen. Rene Garcia, R-Hialeah, and Sen. Garrett Richter, R-Naples, to talk with federal officials over extending funding for the state's Low Income Pool program, according to Gary Fineout of The Associated Press.

Gardiner, an Orlando Republican who works for a hospital, took the unusual step even as top officials with Gov. Rick Scott's administration are directly negotiating with the U.S. Department of Health and Human Services.

The Senate assumes that Florida will take in billions in federal aid, including money the state could receive if it moves ahead with a plan to expand health care coverage to about 800,000 Floridians who are now ineligible, while the House does not.

A spokeswoman for Gardiner insisted that the senators aren’t negotiating with federal officials. Katie Betta said Senate leaders wanted to "have an idea of the federal government's view on where Florida stands."

Meanwhile, a day after Americans for Prosperity sent out mailers attacking the senators who support Medicaid expansion, a coalition of business leaders released a video thanking the Senate for its "bold leadership and courage," according to Kathleen McGrory of The Times/Herald Tallahassee Bureau.

The group, a Healthy Florida Works, was instrumental in drafting the Senate's plan to expand healthcare coverage to nearly one million poor Floridians.

"As highlighted in the coalition’s new video, the Senate's comprehensive health care package will save the state billions, create good paying jobs and provide health care coverage to more than 800,000 Floridians," the group said Tuesday in a press release.

The video is on social media and will run in certain TV markets.

CMS Shuts Down Discussions

Agency for Health Care Administration Secretary Elizabeth Dudek announced Wednesday that federal officials had suspended talks over extending funding for Florida’s Low Income Pool program, according to Gary Fineout of The Associated Press.

In an April 1, 2015, statement Dudek called the news that director for the federal Centers for Medicare and Medicaid Services Eliot Fishman would not be available for negotiations for at least two weeks “sudden and disappointing news.”

Dudek said the move “could signal the abrupt end of this federal healthcare program in Florida.”

The news comes at a critical time: The Florida Legislature is trying to finalize a new state budget between now and the end of the session on May 1. Senate Republicans have vowed that they will not vote for a budget if it requires large cuts to hospitals.

Federal officials did not respond in detail to Dudek. But a spokesman for CMS said the federal government remains "in contact with the state."

The fate of the hospital program, known as the "low-income pool" and which reimburses hospitals for treating the poor and uninsured, has become the major dividing point between the House and Senate this session.

Florida has a projected budget surplus of more than $1 billion. Federal officials warned the state last year they would not extend the hospital money beyond this year. That led the Senate to craft a replacement program that it wants the federal government to consider.

Senate Republicans have also pushed to expand Medicaid as part of the Affordable Care Act. Senate President Andy Gardiner sent two state senators to Washington, D.C., this week to share with federal officials what the Senate is proposing.

House Speaker Steve Crisafulli put out a statement blasting CMS and federal officials for suspending negotiations with the state and said the state would not be "bullied."

"The federal government is doing everything they can to force Florida to expand Medicaid under the ObamaCare model," said Crisafulli.

Gardiner acknowledged that if talks between the federal government and state officials are suspended for two weeks it "becomes somewhat of a challenge" to wrap up work on a new state budget by the end of April. That could force legislators to finish work on a budget during a special session.

AFP targets Gardiner, other senators over Medicaid expansion

The Florida branch of Americans for Prosperity is targeting Senate President Andy Gardiner over his openness to exploring Medicaid expansion in Florida, according to Alex Leary of The Tampa Bay Times.

The group said it is "launching a major grassroots and mail effort to educate Floridians about which state senators are supporting Medicaid expansion." It also released a mailer being sent to Gardiner's Orlando- based district.

AFP implied other senators would be hit with mail pieces.

Our mailing address is: Florida Association of Health Underwriters PO Box 150358 Altamonte Springs, FL 32701

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