Florida hospitals are intently watching the negotiations between the state and federal government over health care funding. The state has been talking to the federal government about renewing a wavier for health care services for low-income Floridians.
Talks with the Donald Trump Administration on federal funding to Florida have dragged on since March. Gov. Rick Scott secured a promise for about $1 billion in federal medical needy money from the federal government. State legislators cut more than $500 million in state Medicaid funding to hospitals based on that promise.
Bruce Rueben of the Florida Hospital Association said Justin Senor, who heads the Agency for Health Care Administration, told lawmakers the Low Income Pool would cover the Medicaid cuts.
“That the representations that the Secretary Senor made to the legislature that the Low Income Pool would be $1.5 billion and that the hospitals would not be harmed by taking the general revenue – we hope those representations are indeed what happen,” he said.
LIP is a federal money the state matches through local government revenue. The state needs to raise $500 million from willing local governments to match the $1 billion in federal funding. Florida health officials and the Trump Administration are working out the terms and conditions under which Florida would get the money. Rueben said it could take until the end of June or longer for a deal. The state has missed previous deadlines for an agreement.
Lobbyist Jennifer Ungru was previously a top member of Agency for Health Care Administration, or AHCA. She said she hopes the LIP money will make up for the state funding cuts. But she said even if it doesn’t cover all the reductions, hospitals still have to treat the sick.
“Well, I would hope that it doesn’t mean that people will have less access to care," she said. "Hospitals can’t turn folks away. That’s kind of the whole purpose of having a safety net.”
But hospitals want to know who’s going to pay for that care if the patient can’t. Florida didn’t expand Medicaid to cover the nearly 900,000 low-income Floridians would have been eligible for coverage.
Rueben said the cuts could lead to less access to medical services, fewer staff hired and higher insurance premiums. While the LIP funding may mitigate the impacts of the cuts, Rueben says they will still be felt.
“The individual hospitals have to certainly prepare for the consequences of these cuts and then they have to make it clear to our communities and to our lawmakers what those consequences are. And we won’t know for sure until we know the terms and conditions of the Low Income Pool.”
Rueben said another threat to hospitals is Congress. He believes the issue of uncompensated care will grow if Congress reduces the number of people able to get health insurance.
But Ungru said she thinks Congress is focused more on insurance coverage than the drivers of cost. Yet, she said she’s excited for the state to have more flexibility to create a customized Medicaid program.
“The way we’re going to make health care more accessible is if it’s affordable,” she said.
The Congressional Budget Office said tens of millions of people would lose coverage through the original House version of repealing and replacing the Affordable Care Act. There’s not yet a CBO score on the version that passed the U.S. House of Representatives. That version could increase insurance premiums for older people and waive coverage requirements for states.