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Florida Gov’t Weekly Roundup: Health Care Funding, Special Session

For weeks now, one question has hovered over Tallahassee: How will the House and Senate resolve their differences on health-care funding and wrap up a special session — scheduled to begin June 1 — with a spending plan for state government?

If the pieces didn’t necessarily fall into place this week, lawmakers and Gov. Rick Scott were at least able to get around to opening the puzzle box.

Scott’s newly created health-care funding commission held its first meeting. But with hospitals giving the panel the cold shoulder and the chairman suggesting the group probably wouldn’t finish the work before the end of the special session, it appeared to be as much political theater as viable solution.

More important was the federal government’s preliminary estimate of the size of a pot of money known as the Low Income Pool program — or, in the parlance of the Capitol, LIP. The nearly $2.2 billion program will now be shaved down to about $1 billion, though the state could make up the difference with some local funds and perhaps state tax money (the House’s preferred solution) or a form of Medicaid expansion (the Senate’s).

However the impasse ends, the wheels of state government have continued turning in the interim. Scott signed dozens of bills this week covering everything from who can carry guns during emergency situations to the funding of pension plans for local police officers and firefighters. And the state’s de facto school-voucher program seems safe — at least for now.

LIPS ARE MOVING

Even before its first meeting, Scott’s Commission on Healthcare and Hospital Funding was not received well by the industry that has so far been the focus of its inquiry. Scott had asked the Florida Hospital Association to submit ideas for revenue sharing to the panel for consideration if the federal government decided not to renew LIP at all.

On Monday, two days before the commission’s first get-together, FHA said “no thanks” (in so many words).

“You have suggested that a new tax on hospital operating surpluses might be a way to sustain the existing LIP program,” hospital association executives wrote in a letter to Scott. “Such an arrangement is not a solution to the challenge we face.”

Instead, the executives pointed to the Senate’s plan to use Medicaid expansion funds to help low-income Floridians purchase private insurance. Scott and House leaders have ruled out that idea.

Individual hospitals weren’t much more conciliatory. Scott asked all of them to fill out surveys on their financial data. Many — though not all — essentially told the governor to look up the information himself.

Many of the dozens of surveys returned by hospitals had five or fewer of the roughly 100 lines filled out with new information. Officials frequently referred Scott back to information filed with the Florida Agency for Health Care Administration, which oversees much of the state’s spending on health care.

“Florida Hospital regularly reports financial and hospital utilization data to the Agency for Health Care Administration, as required by state law,” wrote Joe Johnson, president and chief executive officer of Florida Hospital Carrollwood, in a letter accompanying an essentially blank response to the survey. “We believe our submissions are up to date, accurate and readily available to the public for review. In order to meet your urgent request, we respectfully refer you to consult AHCA to obtain this comprehensive information.”

That didn’t sit well with some of the commission’s members when they gathered Wednesday.

“As a taxpayer, if they receive tax dollars, they should be responsible for giving us the information that would help us make sure that the tax dollars are being spent wisely,” said commission member Sam Seevers, a former Destin mayor.

But whether the panel can even help resolve the budget issues facing the Legislature has become something of an open question.

Carlos Beruff, president of Medallion homes and chairman of the commission, indicated he thought it would be difficult for the group to gather all of the information it needs to help the state navigate those issues in time to help lawmakers.

“I don’t think you’ll have all the data by the end of the special session — no, I don’t,” Beruff said. “But there’ll be more data.”

Beruff would not answer directly how long he thought the panel might work. But asked specifically if it would wrap up by the end of the special session, he merely answered: “It’d be interesting to try.”

The next day, though, lawmakers and Scott had their answer on how much the state would get for the LIP program: about $1 billion.

“We note that this level of funding for the LIP, coupled with the options the state may elect at its discretion described in this letter, would enable Florida to retain Medicaid investment in the state at or above the current $2.16 billion level of LIP funding,” wrote Vikki Wachino, director of the federal Centers for Medicare & Medicaid Services.

The letter did not exactly solve the argument between House and Senate leaders. For Senate President Andy Gardiner and his lieutenants, the reduction in LIP just backed up their call for a Medicaid expansion alternative.

“While the letter from CMS outlines a number of policy alternatives, none of these options will allow Florida to maximize both state and federal taxpayer dollars in a more effective manner than by reducing the number of uninsured Floridians seeking basic health care in hospital emergency rooms,” Gardiner, R-Orlando, wrote in a memo to senators. “Clearly, a conservative free-market expansion of health care coverage is the most fiscally responsible approach.”

But House Appropriations Chairman Richard Corcoran, R-Land O’ Lakes, indicated that he favored a plan that would use state money to make the hospitals whole. The House had pitched a similar idea near the end of the regular session, when lawmakers were unsure what the final size of the LIP program might be.

“Now, the great news is that we’re able to do that with finality,” Corcoran said.

THE REST OF THE STORY

There’s less drama than usual this year about bill-signing season, given that Scott can’t yet use his line-item veto pen on the budget — since one does not exist — and some of the more controversial legislation never crossed the finish line in the messy conclusion of the regular legislative session. This in a session that was one of the least productive in recent memory, at least as measured in terms of bills passed.

But there is still legislation for Scott to consider, and he approved 44 bills on Thursday.

One (SB 290) would allow Floridians without concealed-weapons licenses to carry guns during mandatory emergency evacuations.

“It’s really a no-brainer,” National Rifle Association lobbyist Marion Hammer said. “When people are forced to leave their homes, they have a right to carry their possessions with them — including their firearms to protect their property.”

Scott also signed bills aimed at improving the state’s child-protection and juvenile-justice systems and bills banning job discrimination based on pregnancy and creating tax-free savings accounts for people with disabilities.

The governor also approved a long-discussed bill aimed at shoring up the finances of pension funds for local police and firefighters.

Friday brought more signings, including a bill that would allow children in Florida to secretly record conversations related to sexual abuse or other violent acts

The signing of the measure (HB 7001) came a day after Richard McDade, a Fort Myers man who spent four years in prison on charges of sexually assaulting his stepdaughter, was acquitted by a jury in Lee County. The Florida Supreme Court in December ordered a new trial for McDade, declaring that recordings made by McDade’s stepdaughter should not have been allowed into his initial Lee County trial. State law generally bars recording of conversations unless all parties agree, and it also prevents such recordings from being used as evidence in court.

NO SUIT FOR YOU

School funding is likely to be a topic of discussion during the special session, but another effort by the state’s main teachers union to (in their leaders’ opinion) prevent money from being siphoned away from public schools was dealt a setback Monday.

In a victory for school-choice supporters, Leon County Circuit Judge George Reynolds tossed out a constitutional challenge to a state program that helps send tens of thousands of low-income children to private schools.

Reynolds ruled that plaintiffs in the case — spearheaded by the Florida Education Association — did not have legal “standing” to challenge the Florida Tax Credit Scholarship Program.

The voucher-like program provides tax credits to companies that donate money to nonprofit entities that help pay for children to attend private schools. It includes nearly 70,000 students this year, according to the Foundation for Florida’s Future, a group founded by former Gov. Jeb Bush that is a major backer of school-choice programs.

Patricia Levesque, executive director of the foundation, issued a statement after Reynolds’ ruling and blasted the union, which also led a legal fight that in 2006 blocked a voucher program pushed by Bush.

“In Florida, we’re way beyond sitting back and letting the status quo roll over students’ opportunities and lives,” Levesque said in the statement. “The unions do not speak for the tens of thousands of parents and teachers embracing choices that make success possible for more and more students every year. And thank goodness for that.”

But Joanne McCall, a vice president of the Florida Education Association who was a named plaintiff in the case, said the union thinks the tax-credit scholarship program, like the Bush voucher program, is unconstitutional. She said the union would decide soon whether to appeal Reynolds’ decision.

“It’s time to settle the issue of the constitutionality of vouchers once and for all,” McCall said in a prepared statement. “We think this issue is of vital importance and the citizens of Florida deserve for this question to be decided.”

STORY OF THE WEEK: The federal government announced a preliminary estimate of $1 billion for the state’s Low Income Pool program in the budget year that begins July 1. Questions about that program have complicated efforts by lawmakers to reach a deal on the budget.

QUOTE OF THE WEEK: “Take the Medicaid expansion. It not only takes care of your problem with the LIP, you’re empowering the patient. Oh, my God, isn’t that terrible? You’re giving poor people health care. Oh, that’s awful.”—Tom Brooks, of DeLand, at the first meeting of Gov. Rick Scott’s Commission on Healthcare and Hospital Funding.

by Brandon Larrabee, The News Service of Florida