The CMS is appearing to blink in its stare-down with Florida over Medicaid expansion. The agency informed state officials last week that it tentatively plans to renew a waiver that has provided Florida billions in supplemental Medicaid funding to help hospitals with uncompensated-care costs.
The Obama administration had tied renewal of the waiver—which it warned a year ago was ending—to Florida's expansion of Medicaid to adults with incomes up to 138% of the federal poverty level. HHS and CMS officials have said the administration does not want to provide supplemental hospital-care funding for people that Florida could cover through a Medicaid expansion. The state filed a lawsuit contending the administration was trying to coerce it to expand coverage, which the U.S. Supreme Court previously ruled unconstitutional.
The CMS now appears to have had a change of heart. “We have preliminarily concluded that 2015-2016 funding should be consistent with what the funding will be at $1 billion, consistent with the funding for LIP (Low Income Pool) prior to 2014, to maintain stability while the system transitions,” Vikki Wachino, director of the Center for Medicaid and CHIP Services at the CMS, said in a May 21 letter to the state. Starting in mid-2016, funding will drop to $600 million as “a more sustainable and appropriate level to cover the state's remaining uncompensated-care costs,” she added. The new waiver would end in June 2017.
It's unclear if the lawsuit filed by Gov. Rick Scott's administration will move forward.