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Health Program Money Won't Hit Projections

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
Cheap Health Insurance
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Gov. Rick Scott last year bragged that the Trump administration had agreed to steer $1.5 billion in supplemental Medicaid funding to the state, saying at the time the money will “truly improve the quality and access to health care for our most vulnerable populations.” 

But the amount of Medicaid money that will flow to the “Low Income Pool” program this year is $730.6 million, less than half of the potential amount and about $60 million less than what Medicaid Director Beth Kidder told lawmakers last fall would be available for the state to spend. 

Nevertheless, Agency for Health Care Administration Secretary Justin Senior remained optimistic Thursday, predicting that the state will tap into the full $1.5 billion in supplemental Medicaid dollars at some point. 

“The opportunity is there, and I think that’s the important thing. It will grow over time,” Senior told The News Service of Florida. 

The Low Income Pool, which provides additional funds to hospitals that serve large numbers of poor and uninsured patients, is comprised of money from Florida and the federal government. But Florida doesn’t use state tax dollars for its required match. Instead, the state calls on local governments and local health-care taxing districts to provide “intergovernmental transfers” to fund the program. 

Kidder told senators last fall that the state had $303.3 million in funding commitments from local entities. Combined with the federal money, that would have provided a total of about $790 million for the LIP program. 

Not all commitments came through. The state collected $279 million, which draws down $451.4 million in matching federal Medicaid dollars. 

LIP has been a long-standing program in Florida, and local officials have traditionally contributed more money. 

But counties are less eager to contribute tax dollars now because of restrictions that were initially put in place by the Obama administration in 2015 after the state refused to expand Medicaid under the Affordable Care Act. 

The Obama administration preferred to use Medicaid dollars to provide health insurance coverage instead of funding supplemental risk pools and pared back the size of Florida’s LIP program to $608 million. 

Scott criticized the Obama administration at the time, accusing the Democratic president of punishing Florida for not expanding Medicaid. 

Conversely, Scott praised the Trump administration last year for agreeing to extend what is known as a “Medicaid 1115 waiver” for another five years, saying in a prepared release that it was “refreshing to now have a federal government that treats us fairly and does not attempt to coerce us into expanding Medicaid.” 

Scott at the time dismissed concerns that the state wouldn’t be able to collect enough money to fully fund the LIP program and said the state would “get more flexibility in a lot of things with regard to the Medicaid program.”