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In a year of budget plenty, waiting lists for elderly, disabled trimmed only a little

Sunday, April 13th, 2014 by John Kennedy

Despite a year of plenty for state lawmakers, with overall spending almost certain to hit record levels, relatively meager increases proposed for elderly and disabled programs do little to scale back the massive backlog of Floridians seeking aid.

The state’s waiting lists for elderly long-term health services, community care, Alzheimer’s Disease assistance and help for people with disabilities would shrink by only modest percentages, despite a $1.2 billion surplus of state revenue fueling rival $75 billion House and Senate budget proposals.

Lawmakers are touting this year’s plan to spend roughly $37 million to reduce the number of elderly Floridians awaiting services. But legislators acknowledge the line won’t really be shortened by much.

With the nation’s largest number of people over age 65, Florida has a 9,000-person waiting list for community care services that help keep the elderly in their homes. Advocates say the number of people seeking services could actually be more than three times that.

But in its budget, House is looking to take 751 people off the waiting list; the Senate would add 601 Floridians for care.

Either way, less than 10 percent of those seeking coverage will gain services.

“This is penny-wise and pound-foolish not to spend more,” said David Bruns, spokesman for AARP-Florida. “The cost of people going into nursing homes is so much more. But (legislators) are taking such a small step.”

Full story here:  bit.ly/1kUJURa

 

Congressional Democrats say Scott’s conscience should guide on Medicaid

Wednesday, February 5th, 2014 by John Kennedy

Florida congressional Democrats attempted to turn up the heat Wednesday on Gov. Rick Scott over his walking away from his earlier bid to expand Medicaid coverage for more than 1 million Floridians.

Almost exactly one year ago, Scott held a news conference at the Governor’s Mansion to announce his support for expanding Medicaid coverage, an option given states under the Affordable Care Act. The federal government was poised to fully pay for the first three years of the expansion, and carry the bulk of the financing going forward.

“No mother or father should despair over whether or not they can afford — or access — the health care their child needs,” Scott said at the mansion.

House Speaker Will Weatheford, R-Wesley Chapel, refused to go along with Scott’s idea. And an alternate plan proposed by the Florida Senate also failed, with the House raising concerns about relying on federal financing and fears that Florida taxpayers could wind up owing more than promised.

In his latest budget proposal, Scott doesn’t mention Medicaid expansion. Weatherford and Senate President Don Gaetz, R-Niceville, have already declared expansion dead for the legislative session beginning March 4.

Democratic U.S. Sen. Bill Nelson and other Florida Democrats want to know why.

“Governor, last year you said your conscience wouldn’t allow you to stand in the way of an expansion,” the lawmakers wrote Scott in a letter today. “We hope your conscience now will compel you to at least ask legislators to find a way to get this done.”

 

Scott says Obama was “deceitful” on insurance coverage

Tuesday, November 19th, 2013 by John Kennedy

Most Americans who have successfully enrolled in health coverage under the Affordable Care Act have done so through exchanges organized by 11 states  and not through  the balky federal website.

But Gov. Rick Scott said Tuesday that he has no regrets that Florida did not create its own exchange — even though it may be costing residents access to health insurance.

“Remember, this was the president’s health care bill,” Scott said. “He decided to get this bill passed. He’s responsible for the adverse impact. Three hundred thousand people are losing their insurance at the end of the year.

“Look at what’s going to happen. Cost is going to go up. Quality is going to go down. It’s the president’s responsibility,” Scott concluded.

Scott’s claim about 300,000 people losing insurance apparently disregards the rule change announced last week by the Obama administration that allows insurers to extend current health coverage into next year.

Florida Blue, the big insurer, earlier warned that 300,000 Floridians could have been without coverage — but now will maintain existing policies through 2014.

The Republican governor fought the Affordable Care Act before it became law. But earlier this year, Scott seemed to soften that opposition by endorsing a key feature of the measure — calling for the state to expand Medicaid coverage for low-income residents.

Scott’s fellow Republicans in the Legislature, however, refused to go along.

Since then, Scott has been toughening his rhetoric. And on Tuesday, he said Obama was “deceitful” when the president assured Americans that their existing coverage was not at risk.

“He was deceitful when he said that if you like your insurance you will not lose it,” Scott said. “What people are not thinking about is that…we have people losing their insurance. We know under that bill, the cost of health care is going to go up and we know that quality is going to be impacted. It’s a bad bill and it needs to be repealed.”

Hudson tells Congress expanding Medicaid a “flawed approach”

Wednesday, September 18th, 2013 by John Kennedy

With some advocates pushing the Republican-led Legislature to revisit expanding Medicaid, the House’s health care budget chairman testified Wednesday before Congress that the idea represents a “flawed approach.”

Rep. Matt Hudson, R-Naples, was among officials from several states who spoke on the implementation of the Affordable Care Act and concerns it is raising.

Hudson also defended the Florida House’s rejection earlier this year of expanding Medicaid to cover those who may not be able to afford health insurance even under so-called ObamaCare.

“Fundamentally, I believe the Medicaid expansion is a flawed approach to reduce the number of uninsured residents in Florida,” Hudson told a joint meeting of two U.S. House committees.

“Rather than temporary assistance targeted to our most vulnerable residents, the optional Medicaid expansion would have created a new entitlement for able-bodied, working age adults without children,” he added.

Florida has about 4 million uninsured, one of the largest populations in the nation. About 1.1 million were expected to be able to gain coverage — financed totally by the federal government for the first three years — under the Medicaid expansion allowed under the Affordable Care Act.

“Expanding Medicaid to more than a million new individuals would undoubtedly make access problems worse,” Hudson testified.  “And those who would suffer most would be our most vulnerable residents, including our elderly population and those with disabilities. They would be forced to compete with able-bodied adults for a limited number of appointments.”

Women voters and business groups urge another look at Medicaid expansion

Tuesday, September 17th, 2013 by John Kennedy

Even as Gov. Rick Scott is setting up what critics call obstacles in the path of the Affordable Care Act, some advocates Tuesday began a push for Florida lawmakers to revisit the idea of expanding Medicaid coverage for the state’s poorest residents.

The League of Women Voters of Florida joined with Tampa-area companies and business associations to urge legislators to consider the economic benefits of providing health insurance to the hundreds of thousands of Floridians who still may not qualify or be able to pay for coverage when the federal plan takes effect Jan. 1.

“This makes good business sense for our hospitals by reducing the amount of emergency care they would need to provide for the unisured and it would also help stabilize business health insurance premiums by reducing the need to pass along those costs,” said Bob Rohrlack, president and CEO of the Greater Tampa Chamber of Commerce.

Scott, who earlier this year endorsed the Medicaid expansion, but stood by as the Florida House rejected the approach, has lately raised alarms about the work by “navigators” informing Floridians of their health care options when online marketplaces begin offering insurance Oct. 1.

But Deirdre Macnab, president of the league, said her organization is looking to push more business supporters forward in coming months. She wants the Legislature to revisit expansion next spring.

“No doubt, there will be many bumps on the road,” when it comes to implementing the Affordable Care Act, Mcnab said. “But hopefully, the Florida Legislature will pay attention to the business community and the citizens of this state.”

Florida CHAIN leader leaves for new advocacy role

Tuesday, September 3rd, 2013 by John Kennedy

Laura Goodhue, head of a Jupiter-based health advocacy organization working to link Floridians with insurers under the Affordable Care Act, is leaving for a new South Florida agency.

Goodhue, executive director of Florida CHAIN for almost six years, will join Planned Parenthood of South Florida and the Treasure Coast as vice president of public policy and communications.

Florida CHAIN last month received a $125,000 grant to serve as a Affordable Care Act “navigator” to run public education efforts for consumers and small employers in advance of the Oct. 1 opening of Florida’s federally-operated online marketplace for those seeking insurance.

In a statement, Florida CHAIN said of Goodhue, “Her leadership and dogged dedication has made a critical difference in the lives of Florida’s hard-working families.

“We look forward to continuing to work closely with Laura as we collaboratively educate Florida’s families about the upcoming marketplace and advocate for the expansion of Medicaid.”

Frequent Scott critic, Fasano, appointed Pasco Tax Collector

Tuesday, August 6th, 2013 by John Kennedy

Gov. Rick Scott appointed longtime lawmaker Mike Fasano as Pasco County Tax Collector, filling a vacancy created by the death of Tax Collector Mike Olson — a move the takes a Republican maverick and frequent Scott critic out of the Legislature.

Fasano, a New Port Richey Republican, was elected to the House last fall — beginning his second run in the chamber. He earlier served in the House from 1994-2002, when he was elected to the Senate, where he served the next decade.

Fasano clashed last spring with House Speaker Will Weatherford, R-Wesley Chapel, over Medicaid expansion. Fasano sided with the Senate and Democrats in the drive to accept billions of dollars in federal aid to expand health coverage to 1.1 million poor Floridians. Weatherford refused, warning that the state would likely be stuck with a larger part of the tab from a federal government he said was unreliable.

Fasano also criticized the governor for failing to do more to sell the expansion to lawmakers.

Fasano had earned a reputation as a party loyalist under former Gov. Jeb Bush, being a leading advocate of the governor’s insistence on fazing out the state’s intangibles tax on investments, which he decried as a tax on “seniors and savers.”

He also was an advocate for customers of Citizens Property Insurance Corp., the state-run insurer which is steadily under fire from business associations backing insurance companies which want a bigger slice of the Florida market.

The Pasco job will pay Fasano $136,000 annually, about five times what he earns as a legislator. The job also makes Fasano eligible for a massive spike in his pension benefits.

“He’s passionate. He cares about our state and he cares about his constituents,” Scott said. “He’s going to be very customer oriented.”

Employer mandate delay upends strategy for Florida Medicaid advocates

Wednesday, July 3rd, 2013 by John Kennedy

The Obama administration’s decision to delay for a year the requirement that large employers provide health insurance to their workers likely ended any hopes Florida Democrats had of expanding Medicaid coverage in the near future to low-income residents.

House Speaker Will Weatherford, who rallied House Republicans behind rejecting the expansion allowed under the Affordable Care Act, said that postponing the employer mandate until 2015 affirmed his fear that the federal government was unreliable in the health care expansion.

“Count on more reversals, changes & unraveling of ObamaCare,” Weatherford posted on Twitter following the announcement. “ There is no way the Feds can make good on their promises.”

By Wednesday, Weatherford, R-Wesley Chapel, was joining in a Republican chorus calling for the repeal of the 2010 Affordable Care Act. “ObamaCare should not simply be delayed, but repealed,” Weatherford tweeted.

Sen. Joe Negron, R-Stuart, also was among state Republicans ready to reverse course.

The stance was more of a departure for Negron. The Senate budget chief spearheaded an effort this spring that would have expanded health coverage to  1.1 million more low-income residents and been fully financed by federal dollars its first three years.

Negron’s plan also would have positioned Florida for $51 billion in federal aid over the next decade.

With the federal mandate lifted for a year, Negron said told The Palm Beach Post, “Businesses in Florida now have one more year to understand and try to implement the law and maybe persuade Congress to revisit the entire law.”

He added, “Maybe this is time to start making a persuasive argument to start over from scratch.”

The administration’s decision to tap the brakes on requiring employers with 50 or more workers to begin offering health coverage by January also blunts a campaign already underway by Florida Democrats looking to draw more support for Medicaid expansion.

The Palm Beach County Legislative Delegation is going ahead with a planned July 15 town hall meeting at the county Governmental Center on the Affordable Care Act and rallying support for expanding Medicaid.

But delegation chairman, Rep. Mark Pafford, D-West Palm Beach, acknowledged Wednesday that the one-year delay, “definitely slows things down.”

“The positive thing is that the administration took to heart the concerns the business community was having,” Pafford said. “There always will be changes in a big plan like this and there still will be questions.

“But you have to remember, people would have been in much better shape if we had already gone ahead with the Medicaid expansion,” Pafford said.

He called Weatherford’s lashing out at the Affordable Care Act “amateurish.”

Like the Palm Beach delegation, Broward County lawmakers held a town hall last month to emphasize the positives of having more of the state’s almost 4 million uninsured gain health care coverage under the Affordable Care Act.

The effort also was aimed at fanning the hopes of supporters disappointed by the Florida Legislature’s failure to approve some version of Medicaid expansion to cover Floridians expected to fall through the cracks of the federal health care overhaul.

Many advocates for the poor have joined with hospitals and some business associations in urging lawmakers to revisit the issue as early as this fall in a special session.

Some expected business groups to step-up their demand for the state and federal governments to cover more low-income residents as the employer mandate neared. Employers, advocates said, would welcome the state and federal government  providing more coverage options to low-income workers with jobs, saving companies some expense.

The Medicaid expansion also was seen as drawing business support because it was seen as reducing the overall cost of providing insurance.

But that strategy now looks out the window.

“At this point, we would hope that businesses would still want to do the right thing and make sure they offer insurance to their workers,” said Laura Goodhue, executive director of Florida CHAIN, a statewide health advocacy organization based in Jupiter.

“Businesses also have to remember that 2015 isn’t that far away. They can’t put these actions off forever,” she said.

 

 

Health care advocates warn that not expanding Medicaid will hurt business

Wednesday, June 19th, 2013 by John Kennedy

Florida’s economy will slump if the state Legislature fails to embrace some version of Medicaid expansion, advocates and business analysts warned Wednesday.

The League of Women Voters in Florida and the Florida Health Care Coalition added to a rising wave of summertime drumbeating by supporters of the Affordable Care Act, warning that not extending health coverage to poor Floridians will darken the state’s business climate.

“We’re really working hard to educate everyone that Medicaid is good for individuals, for employers…good for the economy and good for the state budget,” said Karen Van Caulil, president of the Florida Health Care Coalition.

State legislators from Broward and Palm Beach counties have scheduled town hall sessions in coming weeks on health care and the effort to expand Medicaid coverage.

Also, an outreach campaign begins stumping this coming weekend in low-income neighborhoods in Miami and Orlando, as part of the campaign to promote the president’s health care law.

The Legislature ended the 2013 session last month failing to reach agreement on expanding Medicaid. But advocates have been clamoring for lawmakers to revisit the issue, possibly in a special session this fall.  But House Speaker Will Weatherford, R-Wesley Chapel, however, has said nothing has changed to ease his chamber’s opposition to a big expansion.

The business card has been played by supporters before. But Wednesday in a conference call with reporters, advocates again warned that by refusing federal dollars for care, lawmakers were missing an opportunity to jolt the state’s economy.

Also, Bill Kramer, a director at the Pacific Business Group on Health, said a “cost shift” already present in Florida will expand as those with insurance have to contribute to covering a large portion of the population without coverage.

Deirdre Macnab, league president, likened it to “quicksand” for Florida businesses.

“This is something the state simply cannot afford as we begin to rebound from recession,” Macnab said.

Statewide Medicaid managed care gets fed approval

Friday, June 14th, 2013 by John Kennedy

The Obama administration has approved Florida’s two-year-old request to move almost all of the state’s 3.3 million low-income, Medicaid patients into managed care programs, Gov. Rick Scott announced Friday.

Scott and leading Republican lawmakers have long contended that managed care will squeeze savings out of Medicaid, which this year absorbed $21 billion of the state’s $70 billion budget.

Although federal officials pay about 58 percent of the program, the pricetag for Florida taxpayers remains significant.

In its approval letter, CMS said Florida can begin the managed care conversion on a staggered, region-by-region basis no sooner than next January.

The Florida Legislature approved the managed care push in 2011. Earlier this year, the federal Centers for Medicare and Medicaid Services (CMS) approved moving thousands of nursing home and other long-term care patients into HMOs and other managed care programs as early as this fall.

“Florida is leading the nation in improving cost, quality and access in the Medicaid program. CMS’s final approval of our Medicaid managed care waiver is a huge win for Florida families because it will improve the coordination of care throughout the Medicaid system,” Scott said of the full-scale approval. “Healthcare providers can now more effectively manage chronic conditions and work with families to provide preventative treatments.”

Many health care advocates were wary of the state’s move, fearing it could lead to profit-seeking HMOs cutting corners in caring for low-income Floridians.

They cited problems with an Medicaid HMO pilot program begun in 2006 in five counties, including Broward, that was marked by widespread complaints from patients.

Florida CHAIN, a statewide health care advocacy organization based in Jupiter, had fought the conversion of traditional fee-for-service Medicaid to managed care programs.

On Friday, CHAIN said, “The focus now shifts to the state and its efforts to implement this program that will affect access to care for millions of patients in all 67 counties. The countless reports of disrupted, delayed and denied care streaming in from the original five counties are still very fresh in the minds of all stakeholders.”

CHAIN added, “Advocates will continue to monitor implementation and call on the Agency for Health Care Administration, Florida’s Medicaid agency, to put the needs of patients above the interests of companies with a strong financial incentive to limit care.”

Senate Democrats prod Scott for special session on Medicaid

Monday, May 6th, 2013 by John Kennedy

Florida Senate Democrats urged Gov. Rick Scott on Monday to call lawmakers back into special session to work on expanding health care insurance for low-income Floridians.

Scott earlier endorsed a Medicaid expansion allowed under the Affordable Care Act that could bring Florida $51 billion in federal money over the next decade to cover 1.1 million uninsured Floridians.

But the House and Senate deadlocked on the issue — with House Speaker Will Weatherford, R-Wesley Chapel, unwilling to accept any expansion that relied on federal dollars.

Scott did little to break the standoff during the two-month regular session which ended Friday. But Democrats said the governor now has an opportunity to underscore his support for expansion.

“Governor, you are on the record in support of fully implementing the Medicaid expansion so that uninsured Floridians have access to medical care,” the 14 Senate Democrats wrote. “We urge you to put action behind those words and wield your power to protect those people and the many Florida businesses whose fate now rests in your hands.”

Scott spent Monday touring Florida schools, touting a teacher pay raise he had listed as his top priority and was eventually granted by the Legislature, albeit with some modifications.

Scott wanted an across-the-board hike that was turned into a merit-based increase, that may not be distributed in many counties until next year.

The governor so far has said nothing about a special session on health care. In fact, his final comments when the Legislature adjourned Friday night didn’t sound like someone ready to renew the fight.

“The Legislature said, ‘no,’ I said ‘yes,’” Scott told reporters.

He also hinted that any sales pitch on his part would have proved fruitless. “The House and Senate know exactly where I am” on the issue, Scott said.

 

 

Budget debate marks Legislature’s move toward the exits

Friday, May 3rd, 2013 by John Kennedy

The Florida House and Senate began making their first moves toward the exit Friday, debating a $74.5 billion state budget set to be approved on the 60-day session’s final scheduled day.

The budget for the year beginning July 1 is poised to be the largest in state history. In House closing speeches, there was plenty of praise for $1 billion increase in school spending, pay raises for state employees for the first time in seven years, and dozens of hometown projects scattered throughout the budget.

There was also a measure of relief. Legislators were helped by the first budget surplus since before the recession.

“Because of fiscally sound management and making hard decision, today we can celebrate a great time of restoration,” said Rep. Dennis Baxley, R-Ocala.

Most of the outnumbered Democratic caucus, which fought unsuccessfully to expand health care to uninsured Floridians, sided with ruling Republicans on the spending plan.

“There’s light at the end of the tunnel, and it’s not another train,” said Rep. Joe Gibbons, D-Hallandale Beach.

But several Democrats called for Gov. Rick Scott to veto the budget and call lawmakers back into a later special session. Scott had allied with Democrats and the Republican-led Senate in looking to position Florida to draw $51 billion in federal Medicaid money to cover more than 1 million uninsured Floridians.

Rep. Mark Pafford, D-West Palm Beach, was among those who indicated they will vote against the measure.

“The budget is not plugged into the reality that exists outside this chamber,” Pafford said.

Scott schmoozes House floor — says plenty more possible in session’s last hours

Thursday, May 2nd, 2013 by John Kennedy

Gov. Rick Scott has been catching heat for failing to lobby hard on behalf of his call for a Medicaid expansion.

But on the second-to-last day of session, Scott went hand-to-hand with lawmakers, schmoozing his way across the House floor. The rare visit looked mostly genial — and likely included a few thank-yous to House members for approving a version of his manufacturers’ tax break late Wednesday.

Still, Scott said he was not abandoning hope that some version of a health care expansion was still possible in the session’s waning hours.

“As you know, there’s still time left in session,” Scott said earlier Thursday. “A lot of things happen the last week in session. We’ve got a little over a day left in session. So we’ll see what happens. As you know I’ve said making sure we take care of the uninsured and the legislature said no.”

From the House, Scott headed across the hall to the Senate.

 

Slowdown Day 2: House Democrats debate health care on every bill

Wednesday, May 1st, 2013 by John Kennedy

The Florida House lurched into Day 2 of a slowdown Wednesday, initiated by Democrats angry over Republican leadership’s rejection of a plan to draw federal Medicaid dollars to provide health insurance to more than 1 million Floridians.

House Speaker Will Weatherford, R-Wesley Chapel, advanced the session’s scheduled 9 a.m. start by an hour. And an auto-reader continued to be used to read the full text of bills before the House.

House Democratic Leader Perry Thurston of Fort Lauderdale made the rarely used procedural move Tuesday — demanding the full readings to underscore the party’s frustration. A new tactic emerged Wednesday, when Democrats began using floor debate on virtually every bill to highlight the health care expansion.

Environmental bills, water management legislation and even a measure involving the mapping and monitoring of agricultural lands seemed to remind Democrats in debate about the failed health coverage.

Rep. Lori Berman, D-Lantana, was among those speaking. She grabbed her microphone to debate on an otherwise routine bill involving a state organ and tissue registry.

“Unfortunately, we’re not going to allow some people to take advantage of the organ and tissue registry because we’re not going to allow them to receive health insurance coverage,” Berman said.

House Democrats declare war on GOP: S-l-o-w-l-y

Tuesday, April 30th, 2013 by John Kennedy

House Democrats declared a tactical war Tuesday on ruling Republicans.

Outnumbered Democrats demanded that legislation be read in full — a retaliatory move stemming from the GOP’s refusal to support a Senate plan that would draw federal Medicaid dollars and expand health coverage for poor Floridians.

House Speaker Will Weatherford, R-Wesley Chapel, huddled with members of his leadership team after word of the Democratic plot began circulating early Tuesday.  But he couldn’t stop it.

“There needs to be some clarity on the bills, so we need to read them in full,” Weatherford grimly told the House by early afternoon.

House Democratic Leader Perry Thurston of Fort Lauderdale made the rarely used motion that launched the slowdown. Weatherford, anticipating Thurston’s ploy, had House staff dust off an “auto-reader,” which was used to begin reading the lengthy legislation at slow speed.

The machine was last used several years ago, during a similar stand-off between then-House Democratic Leader Dan Gelber of Miami Beach and former House Speaker Marco Rubio.

Earlier Tuesday, the Senate approved its health care proposal on a 38-1 vote. The proposal positions Florida to draw $51 billion in Medicaid dollars over the next decade for creating a Healthy Florida plan that would cover 1.1 million low-income Floridians.

In a mostly partyline vote, the House earlier voted down an amendment that reflected the Senate proposal. The House said it is wrong to rely on the federal dollars and has approved its own plan to use $237 million in state taxpayer dollars to cover 115,000 Floridians.

Democrats, the Senate and Gov. Rick Scott have dismissed the House proposal as mostly worthless.

But the House-Senate deadlock virtually assures that the session will end this week without any consensus on how to expand health coverage in Florida, where almost 4 million are uninsured.

The slowdown also threatens legislation. Reading lengthy bills by machine absorbs time — and Democrats seem willing to let the session expire without much more action.

Amid the slowdown, Thurston issued a statement.

“It’s unfortunate that we have had to take such unusual action today, but my Democratic colleagues and I believe that
a drastic situation requires drastic tactics. The 1.2 million people who can be provided medical coverage under proposed legislation may not be aware of what’s transpiring in Tallahassee. Today, I want them to know that the 44-member House Democratic Caucus stands in support of them.”

Weatherford later said, “It’s a little disappointing and frankly unbecoming for some members to want to slow down the process. We have a lot of work to do. The citizens of Florida sent us here to get work done.”

 

House health insurance vote deepens deadlock with Senate, Scott

Friday, April 26th, 2013 by John Kennedy

The House approved its state-financed plan Friday to extend health insurance to more than 100,000 Floridians, shunning billions of dollars available from the federal government for a more ambitious effort backed by Gov. Rick Scott and the state Senate.

The House 71-45 vote broke along party lines, with Democrats opposing the measure (CS/HB 7169) as unworkable and driven by ideological opposition to President Obama’s federal health care overhaul.

The House debated the measure for six hours over two days, with many Republicans ridiculing the promise of federal dollars as unreliable. But Democrats said the House plan was useless.

“This bill is wrapped in a beautiful box,” said Rep. Mia Jones, D-Jacksonville. “But when you open the box…it’s filled with empty promises.”

Still, Republicans said those criticizing the legislation were missing their best chance to help low-income Floridians. With the Legislature entering its final seven days, the House and Senate have deadlocked over relying on federal Medicaid dollars to cover uninsured.

“If you vote no on this bill, you are voting to deny Floridians the opportunity to buy health insurance,” said Rep. John Wood, R-Winter Haven.

The House proposal would extend health coverage to 115,000 parents, children and disabled Floridians living below the federal poverty line and cost state taxpayers $237 million annually.

Called Health Choices Plus, the House plan would cost low-income Floridians $300 a year, letting them choose from a variety of insurance options supplemented by $2,000 annually in taxpayer contributions.

A family of three earning less than $19,530 would qualify for coverage. But critics say out-of-pocket costs would prohibit many poor from taking part.

Unlike the Senate proposal, Health Choices Plus wouldn’t cover childless adults.

The Senate’s Healthy Florida would cover families with income up to 138 percent of the poverty level, or $26,300 for a family of three, along with single adults earning as much as $15,586. Like the House plan, it also would require those in the program to pay modest monthly fees and co-payments.

The Senate proposal positions Florida to receive $51 billion in federal aid over the next decade, while costing state taxpayers $3.5 billion. The House plan would cost Florida taxpayers more than $2 billion in the same period, while covering one-tenth of those without coverage.

Florida has almost 4 million uninsured residents, one of the largest populations in the nation.

The Senate plan has been praised by supporters for helping cover many low-income workers in the state’s tourism, health care and service industries who currently have no health insurance.

Scott this week began hinting to lawmakers that he may wield his veto pen heavily — killed coveted spending priorities, if they fail to embrace his legislative agenda.  Scott’s salesmanship on the health insurance plan, however, has been low-key.

But Rep. Jim Waldman, D-Coconut Creek, said the Republican governor should retaliate if he is sent the House health insurance proposal.

“Gov. Scott, this Legislature has failed you,” Waldman said Friday. “This House of Representatives has failed you.”

Waldman said, “You need to veto this budget and send us back here to do our job.”

Scott grumbles about his agenda adrift; hints at vetoes

Thursday, April 25th, 2013 by John Kennedy

Gov. Rick Scott grumbled some and hinted Thursday at vetoing some hometown spending sought by top lawmakers if the Legislature fails to act on his legislative proposals.

Scott’s biggest pitch — drawing Medicaid dollars to expand health care for low-income Floridians — looks doomed in the House. The House also has allowed to languish Scott’s push to eliminate the sales tax for manufacturers buying new equipment.

Meanwhile, House and Senate budget negotiators also have dismissed Scott’s $2,500 across-the-board teacher pay raises. They want to hand out the dollars solely based on merit.

“In the budget, for the first time since 2006, we have a surplus. I want to make sure we spend the money well,” Scott told reporters. “So, I would expect, like I did the last two years….I want to make sure we get a good return on our investment.”

Asked if he has targeted some spending already, Scott said, “There’s a lot of projects in there. I’m going to look at them closely. Legislators, I’m sure will want to come explain some spending. I have my priorities. I want to do the right thing for this state.”

Scott keeps calm, carries on, despite priorities adrift

Tuesday, April 23rd, 2013 by John Kennedy

Gov. Rick Scott is being challenged by top lawmakers on his pitch for low-income health insurance and the lone issues he’s labeled legislative priorities — tax breaks and teacher pay.

But Scott Tuesday declined to bad mouth anyone, as the session lurches into its final two weeks.

About as threatening Scott got was in delivering a veiled hint that he’d veto the priorities of House Speaker Will Weatherford, R-Wesley Chapel, and Senate President Don Gaetz, R-Niceville, which include revamping campaign finance laws and ethics changes.

But, Scoff quickly added, “I’ve been very clear…Everybody can have a successful session.”

Weatherford looms as Scott’s biggest obstacle, refusing to embrace his health insurance plan and allowing the governor’s tax break package to proceed at a glacial pace. The governor tried to use logic in convincing the House.

“We don’t have a choice about the taxes that are part of the president’s health law,” Scott said of the federal health care overhaul. “We do have a choice whether we cover individuals that today don’t have health care. I believe that while the federal government pays 100 percent, we should cover those who don’t have access to health care.”

Scott said he didn’t think he had to flex his muscles.

“The Senate president and speaker of the House know exactly where I stand on this, and I’m very hopeful that they’ll do the right thing,” he concluded.

The House has rejected a call by Scott and the Senate to enact a Healthy Florida plan that could draw billions of federal dollars to insure 1.1 million low-income Floridians. Instead, the House has recommended a more modest proposal that uses $247 million of state taxpayer dollars next year to cover 115,000 uninsured Floridians.

Scott, did, however, get slightly worked up over the House’s push for a 6 percent tuition increase for college and university students. Scott and the Senate have rejected that approach.

“I can’t believe that the House wants to increase tuition 6 percent,” Scott said. “Florida families can’t afford it….every time they raise tuition, which they’ve done for five straight years, it impacts the poorest families in our state and their ability to go to college.”

Later, Gaetz said he endorsed Scott’s handling of the delicate end-game negotiations with the House and Senate.

“I think it’s been a good approach….If he were all over us all the time, pounding away repetitively, redundantly on his issues, we’d be saying ‘he’s too heavy handed,” Gaetz said.

“I think the governor proposes, the Legislature disposes,” Gaetz added. “There’s no lack of clarity about where the governor stands at all.”

Senate to House on health expansion: Let’s Make a Deal

Wednesday, April 17th, 2013 by John Kennedy

A Senate budget panel Wednesday approved Sen. Joe Negron’s plan to draw billions of dollars in federal money to expand health coverage to 1.1 million low-income Floridians.

But Negron also offered an olive branch to fellow Republicans in the House — who so far have shunned the federal dollars. Negron, R-Stuart, said he wants lawmakers to not only approve his sweeping Healthy Florida plan, but also the scaled-back approach favored by Rep. Richard Corcoran, R-Land O’ Lakes.

“I think there may be a way we could move forward with something that accomplishes both of our goals,” Negron told the House Health and Human Services budget subcommittee.

The panel OK’d Negron’s legislation (SB 1816) 13-0, with lawmakers from both parties praising the bill — and the dealmaking strategy with a scheduled less than three weeks remaining in the legislative session.

Negron said he envisions lawmakers approving both his proposal and the dramatically smaller House Health Choices Plus plan that covers 115,000 parents, children and disabled Floridians — but not childless adults. As Negron pitched it to the Senate committee, Floridians would have a choice to take his plan or the House program.

A Senate plan by Sen. Aaron Bean, R-Fernandina Beach, which incorporates much of the House approach, also was approved by the committee on a narrower, 6-4 vote. Senate Republicans said it was important to have all options available as the session hurtles toward the finish line.

Sen. Bill Montford, D-Tallahassee, questioned that stance.

“It’s like trying to take two dates to the prom,” Montford said. “You don’t do that where I’m from.”

Montford also cautioned that twin plans — big and little — would give House members the impression the Senate was willing to settle for less.

The House didn’t immediately react. But senators from both parties Wednesday did their best to sell Negron’s plan.

“It’s not about politics. It’s not about Democrats or Republicans,” said Sen. Rene Garcia, R-Miami. “It’s about the health care of Floridians.”

Negron’s Healthy Florida plan would build on Healthy Kids, a program created under late-Democratic Gov. Lawton Chiles that serves 250,000 children, aged 5-18.

Parents pay $15-$20 monthly for health coverage for their children and can choose from at least a couple of private health plans available in each of Florida’s 67 counties.

Negron would reposition Healthy Kids to also allow the adults who could be eligible under the health care law option that provides more money to states expanding Medicaid to families with income up to 138 percent of the poverty level. That would add about 1.1 million adults and children in Florida.

Florida stands to draw $51 billion in federal funding over the next 10 years through an expansion, while state taxpayers would pay $3.5 billion.  The federal government would fully finance the first three years, if Negron’s plan wins approval from the Obama administration.

By contrast, the House proposal would cost Florida taxpayers $237 million annually. But since it doesn’t draw any federal dollars, it could be enacted without review by Washington — although Negron’s deal might change even that.

The House plan would cost low-income Floridians $25-a-month, letting them choose from a variety of insurance options supplemented by $2,000 annually in taxpayer contributions. Negron, however, indicated that financing was likely not enough — and that maybe federal dollars could be added to the program.

With House,Senate deadlocked on health care, a ‘hybrid’ is born

Tuesday, April 16th, 2013 by John Kennedy

With the House and Senate divided over whether to accept federal dollars to expand health insurance for poor Floridians, Senate budget chief Joe Negron said Tuesday that he is open to finding a middle ground.

Negron, R-Stuart, is scheduled to shepherd a proposal through a Senate budget subcommittee Wednesday that relies on federal money to reposition the Florida Healthy Kids program to accept $51 billion in federal aid over the next decade.

Negron wants to create a Healthy Florida program to cover the potential 1 million uninsured adults and children who could be eligible for coverage under the Medicaid expansion allowed states by the federal Affordable Care Act.

The House and Senate have both rejected the Medicaid expansion earlier sought by Gov. Rick Scott, but the governor, Senate leaders, and most health care advocates have since signed onto the Negron proposal.

The House, however, is rejecting the federal money. House Speaker Will Weatherford, R-Wesley Chapel, and his likely successor, Rep. Richard Corcoran, R-Land O’ Lakes, say the promise of a steady stream of federal dollars is unreliable.

Instead, House leaders are advancing a proposal that would cover only 115,000 low-income parents, children and disabled at a cost to state taxpayers of $237 million-a-year.

A similar Senate proposal by Sen. Aaron Bean, R-Fernandina Beach, also is expected to be reviewed by the Senate budget panel Wednesday.

“My goal is for people to have health insurance, with them paying part of these premiums,” Negron said. “I would prefer a premium assistance program along the lines of the Senate plan. But this process requires people of good will to enter into principled agreements with the other side.”

Negron said that some sort of “hybrid” proposal — incorporating portions of his plan and the House proposal — is the only approach that will fly this session.

“I think for any plan to succeed this session, it would have to have elements of the House and Senate plans in it,” Negron said.

Although federal Health and Human Services Secretary Kathleen Sebelius told states last December not to expect full federal funding with a partial expansion of Medicaid coverage, Negron said he felt federal officials will be ready to deal.

“I would think that the federal government would want the citizens of Florida to have private health insurance rather than show up at emergency rooms when it’s too late, frequently,” Negron said.

While the House plan would cover 115,000 and Negron’s approach would bring 1 million Floridians insurance coverage, the senator said it was still unknown how many the “hybrid” will insure.

Almost 4 million Floridians currently have no health insurance. Where will the hybrid land?

“Somewhere in between. It depends on where you draw the line,” Negron said.

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