By Steve Bousquet
Hoping to break the Legislature's worst budget stalemate in two decades, the Senate tweaked its Medicaid expansion plan on Tuesday in the face of continued opposition from the House and Gov. Rick Scott.
It didn't work.
The House offered a cautiously optimistic response, but Scott stepped up his criticism of what he called the Senate's "Obamacare Expansion Plan" and accused his fellow Republicans of trying to impose higher taxes on Floridians.
The Senate changes, subject to committee and floor votes in next week's special session, would drop the requirement that people would first have to be enrolled in a Medicaid HMO for six months. Instead, they could use federal money to buy subsidized insurance on the private market, in what appeared to be an effort to head off House criticism of Medicaid as a "broken system."
In addition, a job-seeking provision for people in the revamped Senate plan would require them to seek work by using the state workforce portal, Career Source. Patients also could enroll in insurance plans on a federal health exchange, rather than using the state-run option, and the Legislature would have to approve any major changes in the plan ordered by the federal government.
"We're acknowledging that we want people insured, and here's going to be our best shot at it," said Senate President Andy Gardiner, R-Orlando. For the first time, Gardiner also said that approval of a healthcare plan is not directly linked to passage of a state budget.
"We fully intend to pass a budget," he said. "You could have a scenario where no healthcare bills get done and we pass a budget and go home."
The House's chief budget-writer, Rep. Richard Corcoran, R-Land O'Lakes, called the revised Senate plan "exciting," but said the House wants guarantees that the Senate will take up several unrelated House proposals, such as expanding ambulatory surgical centers, requiring hospitals to publish price lists, and ending state approval of new hospital beds, a process known as certificate of need.
House leaders say they want to reduce cost by injecting competition into the healthcare arena.
"What we're trying to do is find healthcare solutions for the state," Corcoran said. "I think the House is completely open to a discussion, debate and vote on the Senate plan, and we're hoping the Senate is also open to the House's proposals."
Gardiner said the Senate will debate the House's "second-tier" healthcare proposals, but he could not commit that any of them would pass.
Scott, meanwhile, declared his strong opposition to the Senate proposal and said Senate Republicans want to "inevitably" raise taxes.
"Florida's economy is growing and this year we have over a $1 billion budget surplus," Scott said in a statement. "The Senate's plan to expand Medicaid under Obamacare will cost Florida taxpayers $5 billion over 10 years. A budget that keeps Florida's economy growing will cut taxes and give Floridians back more of the money they earn, not inevitably raise taxes in order to implement Obamacare and grow government."
Scott's blast made it clear that the revised Senate plan would be dead on arrival on his desk, which could open new hostilities among his fellow Republicans in the Senate and make a smooth session more difficult.
Senators are well aware of Scott's two priorities in the special session: a package of tax cuts and more money for public schools.
Even if the House were to approve the Senate's healthcare model, two uncertainties remain: a case pending before the U.S. Supreme Court could nullify insurance subsidies in 30 states, including Florida, and the Florida plan would require federal government approval.
Not since 1992 has the state flirted with budgetary disaster so close to the end of the fiscal year on June 30.
Scott has ordered agencies to make contingency plans to provide critical services in case of what he has called a possible "government shutdown," and has issued dire warnings of teachers not being paid and child abuse complaints being ignored.
Senators accuse Scott of scare tactics and say they will fulfill their one constitutionally required duty: to pass a state budget.
The Legislature will reconvene next Monday, June 1, for a highly compressed three-week special session to finish work on the budget before the fiscal year ends.
The session is scheduled to end June 20, but the state Constitution requires a three-day "cooling off" period before lawmakers can vote on the budget. To stay on schedule, they would have to finish all work on the budget by Wednesday, June 17.
Herald/Times staff writer Mary Ellen Klas contribued to this report.
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