By Tia Mitchell

House and Senate committees met separately but simultaneously to discuss Medicaid expansion on the first day of the special session.

The tone couldn't have been more different.

The Senate Health Policy Committee unanimously approved the chamber's Medicaid expansion alternative, which uses federal dollars to purchase private insurance for poor Floridians who agree to work or attend school and share in the costs of coverage.

The House's health-care committee discussed the Senate plan for the first time on Monday, but questions from representatives indicated many are dubious of its merit and likely to vote "no" when it comes up for a floor vote on Friday. Rep. Paul Renner, R-Palm Coast, said he has concerns about whether the federal government would even approve the Senate plan, expanding what he described as a dysfunctional Medicaid system, and the long-term effects on the state budget.

"It's really not a free proposition for us to expand coverage here; we're going to have to give up things that are very important, like education," Renner said.

The full Senate will vote on its Medicaid expansion alternative plan Wednesday, Senate Bill 2-A. But with the House leadership opposed, it is unlikely that the measure will become law this year.

Proponents of Medicaid expansion are already starting to talk about what they can do over the fall and winter as they look forward to trying again in 2016 when House Republicans may be more willing to support a Medicaid expansion alternative in an election year.

The Senate approved its version of the budget this morning, and it includes funding for the Medicaid plan. For that reason the newest member, Sen. Travis Hutson, was among two who voted "no."

"Right now I'm just not sold on the fact that we're taking the federal dollars for Medicaid expansion," the Elkton Republican said later.

The House will approve its budget without Medicaid expansion funding on Thursday. Representatives from each chamber plan to spend the weekend ironing out a budget agreement, a process known as "conference."

In addition to health-care funding, lawmakers must determine how much to increase education spending, how much money to spend on tax cuts and how to allocate nearly $750 million in water conservation funding earmarked under Amendment 1.

If a compromise on the budget can be reached quickly, the special session could end well before the scheduled June 20 end date.

One key issue for lawmakers is deciding how to implement the federal government's reduction in the Low Income Pool program. The reduction in LIP funding, used to help hospitals and health clinics that treat the uninsured, could drastically impact the bottom lines of safety net hospitals like University of Florida Health Jacksonville.

The House is open to using state general fund dollars to make up the difference for hospitals. The Senate prefers to use federal Medicaid expansion funding, but will be forced to consider other options if that plan fails in the House.

House Speaker Steve Crisafulli said a deal on health-care funding could impact the amount of tax cuts included in the budget. "The reality of $690 million [in proposed tax cuts] certainly isn't there," he said.

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