LIP

Suncoast Community Health Centers

Community health centers that serve poor patients around Florida are worried that new restrictions on state and federal funding could hurt their ability to provide charity care.

Tampa General Hospital

Florida hospitals recently learned that an agreement between the state and federal governments will provide them with up to $1.5 billion to cover care for people who can’t pay.

But local governments will have to put up $559 million in matching funds before hospitals can access all of that money.

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.

Tampa General Hospital

The state budget includes deep cuts to hospitals that serve the poor and lawmakers are betting on federal money to help offset the losses.

Tampa General Hospital

The Florida Senate is proposing $75 million for children's programs at hospitals that serve the poor.

The Safety Net Hospital Alliance of Florida supports the proposal, which would bring in just over $21 million for facilities in the Tampa Bay area.

Last year, lawmakers in Tallahassee fought over how to fund health care for uninsured Floridians. Now two new reports say county leaders are the ones who really need to be concerned.

Health care companies struggling to do business in Florida led the most talked-about news of 2015 here at Health News Florida.

The federal government is standing firm in its decision not to increase funding for indigent health care in Florida next year.

State health officials hoped the Centers for Medicare and Medicaid Services would pony up more than $304 million in matching funds for a program called the Low Income Pool, down from a half billion this year.

One Jacksonville Senator isn't worried about the decrease in funds. At least for now.


Florida’s Low Income Pool program – the issue that brought the Legislature to an abrupt halt this spring - is receiving its fourth temporary extension to continue paying hospitals that treat uninsured people, Politico Florida reports.

Florida Governor Rick Scott on Thursday said he’s dropping a lawsuit against the Obama administration after federal officials agreed in principle to extend federal hospital funds for two more years.

Scott credited the lawsuit with extending the funds, which had been scheduled to run out at the end of the month. The agreement will fund Florida’s hospital low-income pool, but at a reduced cost. Florida will receive $1 billion this year – about half of what the state had been receiving – and $600 million next year.

Florida Governor's Office

The Obama administration and the state have reached an agreement to continue funding the hospital Low-Income Pool for two more years but at a much lower cost.

Tuesday’s announcement says the state will receive $1 billion this year, which is about half the current amount, and $600 million for 2016-2017. The fight over the funds tore apart the legislative session and prompted Gov. Rick Scott to file a lawsuit against the federal government. That lawsuit appears to be intact.

House, Senate Agree On LIP Total

Jun 8, 2015
Sammy Mack / Health News Florida

After months of federal negotiations and proposals floated by Gov. Rick Scott, the House and the Senate, lawmakers on Saturday reached tentative agreements on how much money should flow to hospitals and other medical providers that care for large numbers of low-income patients.

Arguments Set In Scott LIP Lawsuit

Jun 8, 2015
Florida Office of the Governor / Florida Office of the Governor

A U.S. District Court judge will hear arguments June 19 in a lawsuit filed by Gov. Rick Scott against the federal government in a dispute about the Low Income Pool health-funding program.

Chief U.S. District Judge M. Casey Rodgers issued an order Thursday scheduling the hearing on Scott's motion for a preliminary injunction in the case.

FL Groups To Back Feds In LIP Lawsuit

Jun 3, 2015

A federal judge this week agreed to allow the League of Women Voters of Florida, Florida Legal Services and Florida CHAIN to file a brief supporting the Obama administration in a lawsuit filed by Gov. Rick Scott about major health care issues.

Chief U.S. District Judge M. Casey Rodgers issued an order Tuesday granting the groups' joint request to file the brief. Scott's lawsuit has sought to prevent federal officials from linking an extension of the Low Income Pool, or LIP, health-funding program to a potential expansion of Medicaid.

Feds Take Aim at Gov. Scott's LIP Lawsuit

Jun 2, 2015

Describing the state's arguments as "baseless," federal officials this week fired back in court against Gov. Rick Scott's contention that the Obama administration has unconstitutionally tried to link expanding Medicaid with the continuation of a key health-care funding program.

Abe Aboraya / WMFE

Gov. Rick Scott’s hospital commission, tasked with looking at how taxpayer dollars are used to support health care for the poor, discussed performance funding for hospitals at a meeting Tuesday in Orlando.

The nine-member group delved through detailed hospital statistics, and started brainstorming ideas for how to reform hospital payments.

Tom Kuntz, a former chairman of SunTrust, helped build performance funding metrics for Florida’s university system. Kuntz says the hospital commission could look at a similar system for hospitals.

The Obama administration has made an offer that it hopes will resolve Florida’s $1 billion state budget stalemate over health care funds for poor people.

Federal health officials agreed to extend Florida’s hospital funds for another two years, but only at about half the amount the state received last year. That means Florida lawmakers may have to dip into the state budget to fill the gap or state hospitals will get less money in the coming year.

In a letter Thursday to Gov. Rick Scott, federal officials stressed that they would not use Low Income Pool hospital funds to cover anyone who could be covered by Medicaid expansion, but they also acknowledged the loss of those funds may be difficult for the state. The current hospital funds are $2.1 billion dollars, put up by the state and federal government. The administration’s preliminary offer drops that to $1 billion for the 2015-2016 fiscal year and to $600 million the following year.

The proposal is still subject to a formal review but federal officials said they wanted to work with the state in good faith, recognizing that the Legislature needs to pass a budget by June 30 to avoid a state government shutdown.

“The decision about whether or not to expand Medicaid is a state option … (R)egardless of whether a state expands Medicaid, uncompensated care pool funding should not pay for costs that would be covered in Medicaid expansion,” federal health officials said in the letter.

The funds, which are part of a federal program that covers the hospital bills of uninsured and Medicaid patients, were supposed to end this year as President Barack Obama’s health care program grew. Patients covered by the low-income pool were supposed to be covered by Medicaid, but the Florida House and Scott have balked at expanding it.

The bitter standoff between the Republican governor and the Obama administration tore apart the state legislative session, with the House abruptly adjourning three days early last month. Scott sued the Obama administration, comparing federal officials to the TV mobster show “The Sopranos” and accusing them of withholding the hospital funds because the state wouldn’t expand Medicaid.

The dispute created a $1 billion hole in the governor’s budget that should now be much easier for lawmakers to address when they return for a special session June 1.

Scott pressed for the extension for months, even visiting Washington twice and blaming the Obama administration for ruining his budget and ignoring his timeline even though he’s known for more than a year that the funds were ending. He waited until mid-April to submit a proposal, although the months-long required public comment period made it impossible to get an answer before the Legislature adjourned last month.

The Obama administration and hospitals want the governor to expand Medicaid to more than 800,000 low-income Floridians and will not spend federal hospital funds on those who would be covered by Medicaid expansion. That’s because federal health officials say it’s more efficient to use the money to give people health insurance than to pay hospitals for caring for the uninsured retroactively.

But Scott and Republican House leaders refuse to accept any money tied to the Affordable Care Act - including Medicaid expansion. They even snubbed a Senate proposal that would eventually take billions of federal dollars and allow the Medicaid expansion recipients to buy private health insurance - a solution that Scott has fought for in the past.

The House and Senate recently announced they would discuss Medicaid expansion during the special session, snubbing the governor’s call to focus only on the budget.

Senate leaders had prepared to move ahead with a health care coverage plan during the upcoming special session, but the announcement from the federal government bolsters the argument of House Republicans who maintained that the state would continue to receive a decent chunk of the hospital money without having to expand Medicaid.

During a recent closed-door session, House and Senate budget chiefs discussed the House’s objections to the Senate’s current proposal. Senate budget chief Tom Lee agreed there were “reasonable” concerns raised about the Senate plan.

The quagmire in Tallahassee over health care spending forced an early end to the spring legislative session. At the heart of it is a federal program known as the Low Income Pool, or LIP. It reimburses Florida hospitals more than two billion dollars a year for providing care to low-income or indigent patients. The federal government is phasing the program out as it shifts to new programs provided by the Affordable Care Act, or Obamacare. 

Now, Gov. Scott is making the rounds in Washington D.C., trying to prod the feds to keep funding LIP. Now, Scott has backtracked from his previous position on supporting expansion of Medicaid in the state to serve low-income residents.

Scott recently spoke to reporters in the nation's capitol.

"The families that are covered through the Low Income Pool is a different group of individuals than are covered by Obamacare," Scott said.

Click on the video below to hear what he had to say about LIP and Medicaid:

PolitiFact Florida rated his statement "Mostly False," saying:

This makes it sound as if the people who would qualify for Medicaid under an expansion are completely different than patients who leave hospitals with unpaid bills the LIP fund helps pay to providers. Health policy experts said that while there would still be uninsured people not paying their bills under an expansion, plenty of overlap exists between the two, especially at lower incomes.

Florida Republican Gov. Rick Scott says he and the Obama administration are still far apart on health care financing issues that have paralyzed the state's efforts to pass a new budget.

After meeting privately with federal Health and Human Services Secretary Sylvia M. Burwell on Wednesday, Scott said the two "had a good conversation," but added, "we don't have resolution."

Governor Rick Scott is following through on a promise to examine the finances of Florida’s public hospitals.  The move comes as an impasse between the legislative chambers deepens.

How will Florida keep paying healthcare costs for its poor and uninsured? That issue has brought the state legislative session to a halt. But it’s getting public hearings this week. On Thursday, the Florida Agency for Healthcare Administration brought the discussion to Doral - and South Floridians are especially anxious.

The Florida House has adjourned for the 2015 lawmaking session. The move comes as the legislature was gridlock over whether to expand Medicaid under the Affordable Care Act.

Associated Press

Florida Gov. Rick Scott sued the Obama administration Tuesday, charging that federal officials are coercing the state to expand Medicaid in order to get $1 billion in federal hospital funds.

The Republican governor points to a 2012 U.S. Supreme Court decision saying the federal government can't coerce states to expand Medicaid, which is exactly what he says the Obama administration is doing by withholding hospital funds.

Florida Legislature

 Top Republicans in the Florida House made an offer Thursday to try to bridge a budget gap with Senate Republicans, but it could still result in the state's hospitals getting significantly less than they are receiving now.

House leaders offered to trim back spending on tax cuts and education - in order to boost spending in the state's safety net health care program. The offer, however, would be unconnected to a push by the Senate to expand Medicaid or revamp an existing program that takes federal money for hospitals.

Health Expansion, LIP Program Divide Budget Proposals

Mar 19, 2015

In a move that creates a $5 billion divide with the House, the Senate released a budget proposal Thursday that banks on expanding health-care coverage for low-income Floridians and extending a critical funding program for hospitals.

The Senate proposal, approved by a key budget panel and touted by President Andy Gardiner, reinforces that health-care funding could be the most-vexing issue facing lawmakers during the rest of this year's legislative session.

Health Expansion Moves On in Senate

Mar 17, 2015
Florida Senate

 Defending the possible acceptance of billions of dollars in federal money, a Senate panel Tuesday unanimously approved a plan that would extend health-care coverage to about 800,000 low-income Floridians.

The plan (SB 7044), backed by the Senate Health and Human Services Appropriations Subcommittee, appears to be moving quickly in the Senate. But House Republican leaders, who for the past two years have flatly rejected accepting federal money to expand coverage through Medicaid or another program, have given no indication they will go along with the Senate.

Speaking after Wednesday’s Cabinet meeting, Florida Gov. Rick Scott echoed House Speaker Steve Crisafulli’s statements on the prospect of losing federal funds for hospitals treating low income patients.  Scott claims expanding Medicaid would not replace low income pool, or LIP, funding.

“LIP is completely separate from Medicaid expansion,” Scott says.  “If you go look at Texas, go look at California, one expanded Medicaid, one didn’t, and both of them are getting significantly more dollars under LIP than what Florida’s getting today or ever gotten.”

Scott's Budget Includes Iffy Fed Money

Jan 30, 2015
Florida Office of the Governor / Florida Office of the Governor

Despite uncertainty about whether the federal government will agree to continue the program, Gov. Rick Scott's proposed 2015-16 budget includes funding for a program that many hospitals say is crucial to caring for poor and uninsured patients.

A Senate health committee learned Wednesday that an independent review of the Low-Income Pool funding for poor and uninsured people should be submitted by next week, the News Service of Florida reports. Federal officials required an independent study of possible changes in the program, which provides the state $1 Billion a year, but is set to expire June 30, according to the News Service.

Florida hospitals have just one year to repay $267 million for Medicaid charges the federal government says it shouldn’t have covered during the past eight years, the Times/Herald Tallahassee Bureau reports.

State and hospital officials are asking for three years to pay back the overpayments to hospitals through the so-called Low-Income Pool fund, saying one year would leave them in dire straits.

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