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Florida House Seeks End to Budget Stalemate

The Florida House made an offer on health care funding Thursday in hopes of ending a budget stalemate with the Senate in the final day of the legislative session.

By Tia Mitchell

The Florida House made an offer on health care funding Thursday in hopes of ending a budget stalemate with the Senate in the final day of the legislative session.

House Speaker Steve Crisafulli would add $200 million from the state to the Medicaid program, which would bring in another $305 million federal funding. That could offset reductions in the Low Income Pool, or LIP, program that helps hospitals and health clinics care for uninsured patients.

Crisafulli said he hopes this proposal will entice Senate President Andy Gardiner to agree to start budget negotiations on Monday. The House has already scheduled meetings to that effect; the Senate has not.

"It's an offer," Crisafulli, R-Merritt Island, said. "It's a conversation, and that's what we've been trying to get going."

The House funds its health care spending increase by reducing a planned boost in education spending by $90 million and decreases the chamber's tax cut package by $78.5 million. The rest comes from reserves.

Gardiner said he hadn't been able to review the proposal by late Thursday but is open to hearing Crisafulli out as the regularly scheduled session enters its final week.

"Many of the outstanding items are related to the budget, so the president appreciates the offer Speaker Crisafulli made this afternoon and is looking forward to working together as we head towards the finish line," Gardiner spokeswoman Katie Betta said in a statement.

Although both chambers agree that they will not be able to complete a balanced budget by the May 1 scheduled end of session, the House offer makes it clear that members are hoping to work things out sooner rather than later.

There is still a possibility that the Legislature will break for a several days or weeks and come back to finalize the budget.

The fiscal year begins June 30.

The House and Senate approved very different versions of the budget at the beginning of this month. The Senate's plan is $4.2 billion larger, mainly because it includes both a renewal of the LIP program and Medicaid expansion.

The $2.2 billion LIP program is scheduled to expire in June. The federal Centers for Medicare and Medicaid Services is reviewing Florida's renewal proposal, drafted in the Senate, which would keep LIP going for two more year.

However, the federal government says it is likely to reduce LIP funding because it disagrees with giving Florida hospitals money for uncompensated care while the state turns down money that could get more people insured.

The House has refused to entertain the Senate's Medicaid expansion plan, which state analysts say would use $8 billion in federal money over the next five years to purchase private insurance policies for roughly 600,000 people who qualify.

The LIP program is funded primarily by about $850 million in local dollars -- including $26 million from Jacksonville -- that qualifies for a $1.3 billion federal match. If CMS ultimately reduces the federal share of the program, the House's offer of general revenue could prevent an overall decrease in money coming to hospitals.

But that doesn't mean individual hospitals won't see a change in funding, depending on the mechanisms and formula used to back-fill any LIP reductions.

For example, UF Health Jacksonville currently gets $95 million in LIP dollars. If that is reduced and the state does not completely replace those dollars in another way, UF Health administrators say the hospital is at risk of closure.

Crisafulli said his goal was not to ensure individual hospitals are kept whole if the LIP program changes.

"We all have to budget from time to time, and sometimes restructuring our budgets is important," he said. "Listen, they've built their budgets around what I would call a lottery."

(c)2015 The Florida Times-Union (Jacksonville, Fla.)

Caroline Cournoyer is GOVERNING's senior web editor.
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