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Lawmakers Mulling Medicaid, Budget

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


House and Senate leaders weren’t backing off their opposing positions on Medicaid expansion  Friday during tense budget negotiations leading into the final week of the Legislative session.

But they did manage to find enough common ground to jump-start negotiations early in the day, only to watch them grind to a halt by evening.

The Senate insists that expanding Medicaid insurance to more than 800,000 low-income Floridians is better than reimbursing state hospitals that care for the uninsured. The Senate is hoping to sway the House Republicans to its position, an unlikely prospect, by proposing to use money saved by Medicaid expansion to boost education spending.

Senate leaders said they want to finish the budget before the session ends next Friday but reminded lawmakers that insurance for hundreds of thousands and $1 billion in hospital funds “are hanging in the balance of these negotiations. Short-term costs are less important than long-term cost effectiveness when the resolution of critical health care issues impacts every Floridian,” according to a statement from Senate President Andy Gardiner.

But House Speaker Steve Crisafulli remained firm that the House will not consider any budget proposal that contemplates some type of expansion of Medicaid – even the Senate’s proposal, which would ultimately allow Medicaid recipients to buy private insurance. Under the Senate proposal, recipients would also be required to work or attend school and pay small monthly premiums.

“It’s important for us to separate the policy from the budget,” Crisafulli said.

Crisafulli could not say exactly what the next step would be for lawmakers. He said the House would be willing to extend the 60-day session if they start budget negotiations in the next week, but otherwise, he said, they would end next week and then “reset” in the weeks to come.

The state’s fiscal year ends June 30, and if a budget is not in place by then, Florida would have to shut down some of its government operations.

“We’re at a point right now where we just got to get past the starting line,” Crisafulli said.

Earlier Friday, the House upped its proposal from $200 million to $600 million to use general revenue funding to offset the potential loss of hospital funds from the federal government.

The Senate instead wants to extend the session for 30 days while waiting to hear whether federal health officials would extend the hospital funds for another year, but the House proposal would mean the contingency funds would be used automatically if the U.S. government cut their funding.

An extended session would allow the Senate to keep pressure on the House and Gov. Rick Scott, who also opposes expanding Medicaid. The Senate has also refused to set aside any money so far for tax cuts pushed by Scott and House Republicans.

Earlier this week, House leaders were heard behind closed doors encouraging one another to hold strong, despite the negative publicity a special session might generate, and not to waiver on expanding Medicaid, which is a key component of President Obama’s health law. Both sides would have to agree to an extended session. If they do, it would keep all bills alive instead of having to start from scratch in a special session later.

The Senate also wants to keep about $600 million in reserves in case the federal government decides not to extend the more than $1 billion per year in hospital funds. Federal health officials have been clear that Medicaid expansion must be part of the conversation, adding pressure to the standoff between the House and Senate.

“We are not willing to rush to a resolution that could damage our economy – particularly when there is a clear alternative available to maximize federal taxpayer dollars returning to Florida while staying true to the Medicaid reform principles we all support,” Gardiner said.