BRADENTON, Fla. - Faced with losing billions in federal funds for low income health insurance, Florida House and Senate Republicans are more than $4 billion apart on the 2016 state budget in a disagreement over Medicaid expansion.
GOP-led budget proposals, with the House at $76.2 billion and the Senate at $80.4 billion, differ largely on the issue of expanding insurance coverage for the poor through the Medicaid program.
Both chambers, along with Gov. Rick Scott, have previously opposed providing coverage for 800,000 low-income Floridians who fall in the gap that prevents them from qualifying under the Affordable Care Act or Medicaid.
Last year, Scott changed his mind while the Legislature remained against expansion.
Scott, however, has not backed a plan initiated by the Senate this year to create the Florida Health Insurance Affordability Exchange, or FHIX, because the federal government has said it will no longer give the state a waiver that provides about $1.3 billion a year for hospitals to treat low income and uninsured patients.
FHIX still hinges on getting approval from the federal government. The program would require enrollees to prove annually that they are working, volunteering, going to school, or actively looking for a job.
If approved, the state would be in line to drawdown up to $2.8 billion in federal aid the first year.
"We believe our budget addresses concerns the federal government has outlined regarding the current hospital funding partnership, which comes to an end on July 1," said Senate President Andy Gardiner, R-Orlando, a vice president at the nonprofit Orlando Health, who supports the exchange.
"Coupled with our new market-driven approach to offering private health insurance options to Floridians in the coverage gap, we believe the federal government has every reason to approve the Senate plan for Medicaid sustainability," he said.
Flush with a surplus of more than $1 billion, the House's spending plan is still $846 million less than Scott's budget proposal for $77 billion and does not include the Senate's health exchange plan.
House Speaker Steve Crisafulli, R-Merritt Island, a real estate broker and agribusinessman, opposes Medicaid expansion.
The House budget incorporates $690 million in tax cuts, including Scott's 3.6% reduction in the communication services tax on phone, cable and satellite television bills as well as eliminating sales tax on college textbooks.
The Senate plan does not include any tax cuts. However, officials have said that cuts will be considered if the federal government approves its health care exchange. Those details are likely to be subject of negotiation as a conference committee works on finalizing the budget.
"The Legislature faces a bumpy road to Florida's final budget as the House and Senate work to bridge the very large gap between their budget proposals in the next several weeks," said Kurt Wenner, who is vice president of research for the nonprofit research group, Florida TaxWatch.
"Despite the initial sticker-shock difference created by the health care issues, the budgets are very similar in many other categories," Wenner said.
Total bond authorizations in the House and Senate budgets were not immediately clear. The House included $205 million of bonds to finance environmental programs for the first time in years. The Senate's version reportedly includes some bonding for transportation programs.