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Rick Scott
Florida Gov. Rick Scott
The fact that Florida's Republican governor and legislature refused to expand Medicaid under Obamacare was bad enough. Florida has the second highest number of uninsured people among all the states. About one quarter of Florida's population was uninsured before the health exchange opened in January. That's 3.8 million people. If the state were to expand Medicaid, one million of them would get Medicaid coverage. But it gets worse. Florida isn't just turning away Medicaid expansion money, they've jeopardized existing funding by refusing to comply with federal Medicaid law. The state has decided to impose a limit of six emergency room visits per year to Medicaid patients. The feds say Florida can't do that, Florida says, sure we can. And now they're losing funding.
The Florida Agency for Health Care Administration is in the midst of an appeal of the federal government’s rejection of the six-visit limit. A September hearing is scheduled.
But while the fight has been pending, the state agency went ahead with its plan. [...]

It’s unclear yet how much the state could be penalized. CMS says it will initially withhold 10 percent of whatever the state claims for certain administrative costs. That amount will go up 5 percent each quarter while the state remains out of compliance.

The state knew it was out of compliance imposing these limits because when they asked the feds for a waiver to do it, they were turned down. They knew that they could lose funding, and did it anyway. But that, as well as expansion refusal, are just part of the major Medicaid fiasco for Florida. The state has also passed a law back in 2011 that will be implemented in July, and could cost some hospitals in the state hundreds of millions of dollars. The law set up a new distribution system for funding, redistributing federal Medicaid dollars around the state.
Jackson Memorial Hospital is bracing again for big cuts—this time, the result of a new law that will send millions of federal dollars that used to go to Miami-Dade hospitals elsewhere in the state.

When the provision takes effect in July, healthcare systems across Miami-Dade County stand to lose $218 million in Medicaid matching funds, also known as Low Income Pool funds.

Jackson alone will shoulder a $140 million hit.

“That would be fairly catastrophic,” Chief Executive Officer Carlos Migoya said. “We’re at a point right now where we are fairly efficient. It’s not like we have a whole lot of extra fat to cut.” [...]

Taken as a group, the state’s safety-net hospitals would be the biggest losers, enduring a total $300 million hit.

Of course. Because it's Florida, and the powers that be there just really don't care.

Originally posted to Joan McCarter on Mon Mar 03, 2014 at 12:48 PM PST.

Also republished by DKos Florida, North & Central Florida Kossacks, and Daily Kos.

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