Tampa Bay Fox television station WTVT left out the fact that Florida Republican Gov. Rick Scott and the Republican-led legislature refused to expand Medicaid under the Affordable Care Act (ACA) in its story about an ailing young boy whose family might have to struggle to pay for health care as a result of reductions in federal Low-Income Pool (LIP) funding, even though experts say that expanded Medicaid would cover many such people at risk.
In a July 13 report, WTVT - which is owned and operated by parent company 21st Century Fox -- profiled a seriously ill young boy whose medical care could be jeopardized by reductions in federal LIP funding - money provided by state and federal resources “to support health care providers that provide uncompensated care to Florida residents who are uninsured or underinsured.” While the report noted that federal matching funds for LIP would be phased out in the near future, it made no mention of the fact that expanding Medicaid in Florida -- which the state legislature and Gov. Scott has rejected -- would protect many families and individuals affected by LIP funding reductions:
Experts agree that expanding Medicaid could solve many of the problems created by reduced LIP funding. As the Center on Budget and Policy Priorities explained, reductions in LIP funding are a result of the ACA's “creation of an explicit pathway for Medicaid coverage for adults with incomes below 138 percent of the poverty line, which changed CMS's (Centers for Medicare and Medicaid Services) criteria for approving state plans to fund uncompensated care.” As Politifact Florida reported, the two programs are not directly connected, but Gov. Scott's acceptance of the Medicaid expansion funds could mean continued health care coverage for many who currently benefit from LIP funding (emphasis added):
The LIP started in 2005 and was renewed until 2013. But when it came time to negotiate another extension for 2014 and beyond, Florida upped the funding request to a whopping $4.5 billion to expand the program. This was after the state refused some $51 billion in Medicaid expansion money over 10 years under the Affordable Care Act, to expand that program to anyone making up to about 133 percent of the poverty level, as the Obama administration wanted. The U.S. Supreme Court in 2012 ruled states had a choice whether to take the money or not.
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In many ways, LIP isn't associated with Medicaid expansion, [Joan] Alker said, given that LIP started while Jeb Bush was governor and George W. Bush was president. But an expanded Medicaid would cover many of those patients, or use preventive care to keep them out of the hospital to begin with, she said.
Washington and Lee University professor Timothy Jost added that money for the Medicaid expansion was guaranteed by law in the Affordable Care Act, something not true about the program that created LIP, which is doled out as discretionary spending. (Jost supports the health care law.)
Of course, it's technically possible the federal government could change the law to do away with whatever program they like, including Medicaid. But that would require both houses of Congress and the president to agree on the terms, something “that isn't likely to happen anytime soon,” Jost said.
Now Florida faces a tough set of choices: Find a new source of LIP funding, end the program altogether or negotiate with CMS to either revamp the program or get another extension, possibly for as short as one month. Florida also could decide to cover those patients by expanding Medicaid.