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Gardiner: Send Full FHIX Plan to Feds

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

Florida Medicaid’s request that federal officials send the state $2.2 billion dollars to keep the Low Income Pool subsidies flowing to hospitals won’t work because a vital part is missing, Florida Senate President Andy Gardiner says.

The missing link, he said, is the Florida Health Insurance Affordability Exchange, known as the FHIX. It is the Senate’s plan to cover up to 1 million of Florida’s low-income uninsured residents by accepting billions of dollars in Medicaid expansion money under the Affordable Care Act.

Gardiner’s letter, released around noon Monday, urges Medicaid Director Justin Senior to send federal officials the Senate’s FHIX plan right away to meet the guidelines set down by the Centers for Medicare and Medicaid Services (CMS).

Without expanded coverage, Gardiner wrote, “the state may not be successful” in its quest for the LIP funds. The LIP program, part of a 2005 waiver, expires June 30.

It would be a surprise if Gardiner’s request were granted. The Medicaid program, part of the Agency for Health Care Administration, answers to the governor’s office. And Gov. Rick Scott, like the Florida House, currently opposes taking the Medicaid expansion money.

The ensuing stalemate over the federal money has prevented the House and Senate from reaching an agreement on the budget, which needs to be on legislators’ desks on Tuesday in order to end the session on time this Friday.

Last week, the House suggested using $600 million in state tax revenue to fill part of the LIP gap for hospitals. But the Senate rejectedthat on the grounds that no additional uninsured people would be covered and it would forfeit billions of dollars in federal funds available to Florida. 

In the memo, Gardiner reminded Senior that CMS provided guidelines for Florida to follow if it wants more LIP money. They were outlined in an April 14 letter to Senior from the CMS official in charge of Medicaid, Vikki Wachino.

Gardiner said the proposal for continued LIP funding that Senior sent to CMS covered some of the guidelines but not others. 

The most important omission, he said, was that Florida Medicaid was still proposing using LIP money to cover hospital costs for patients who would already have had their costs covered through health insurance if the state had expanded Medicaid.

In other words, the CMS guidelines said a state shouldn’t request federal money for something that would not be needed if the state used money already available.

Carol Gentry is a reporter with WUSFin Tampa. Health News Florida receives support from the Corporation for Public Broadcasting.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.