Federal health officials said publicly for the first time Tuesday that they want expansion of Florida's Medicaid program as part of any deal to grant Gov. Rick Scott's request to help the state's hospitals treat poor patients.
Scott, so far, is refusing and with neither side backing down, that could lead to the Legislature failing to pass a budget before the scheduled end of its annual session May 1. Senate leaders say they will not approve a final budget that includes large cuts to hospitals.
The Republican governor has maintained that his opposition to Medicaid expansion, which he supported two years ago, is due to the contentious nature of recent talks with the federal government. Scott has said he no longer trusts the federal government and his administration contends Obama administration officials halted negotiations earlier this month.
"Why would we put taxpayers on the hook when we can't trust the federal government to fulfill a program they already started?" Scott asked on Tuesday.
Federal officials, however, continue to dispute that they halted negotiations. Emails obtained from The Associated Press this week show that state officials and federal officials remained in contact over the past two weeks but the Scott administration has drawn a distinction, saying there haven't been any face-to-face meetings or scheduled phone calls since late March.
Florida's Senate leaders, meanwhile, have also begun to raise questions about how serious the Scott administration was in seeking a resolution to the looming problem. They point out the federal government first warned the state a year ago that it would not continue $1.3 billion in federal funding for the hospital program known as the "low-income pool" beyond this summer.
"We have known this was coming for a year, and here we are, we're being asked to close out a budget and do tax cuts and all these different things and the reality is, you have a huge hole in your budget," said Senate President Andy Gardiner.
The Senate passed a budget that includes a revamped hospital funding model, but it also calls for expanding health coverage to more than 800,000 low-income Floridians. The House budget, which is $4 billion less, does not include Medicaid expansion. House Republicans maintain that the federal government can reauthorize money for hospitals without drawing down federal money linked to President Barack's Obama federal health care overhaul.
In their letter, federal health officials said Medicaid expansion is linked to the hospital fund negotiations and that expansion would give hospitals more paying customers, bring thousands of jobs to the state and let Florida tap into billions of federal dollars. The letter marks the first time federal officials have publicly stipulated Medicaid expansion as a condition of extending the hospital funds.
The letter obtained by The Associated Press states that expansion is an "important consideration" in the federal government's "approach" regarding whether or not the hospital money will be continued past June.
Tuesday's letter reminded the state that they were granted an extension with the caveat that they must come up with an alternate funding plan.
"I am available at your earliest convenience to discuss next steps," said Vikki Wachino, acting director of the Centers for Medicare and Medicaid Services.
The dispute is threatening to derail the entire session. The Florida Senate is expected on Wednesday to grill the head of the Agency for Health Care Administration about the situation since that agency oversees Medicaid and the "low-income pool" program.
House Speaker Steve Crisafulli, meanwhile, criticized federal officials and the Senate for not making it clear previously that Medicaid expansion and the hospital funds were linked. He insisted the discussions would remain separate.
"It is unthinkable that they would leave our state on the hook for over a billion dollars simply because they want a specific policy outcome," the Merritt Island Republican said in a statement
