Florida governor files lawsuit against feds over Medicaid expansion: 10 things to know

Florida Gov. Rick Scott has filed a lawsuit against the federal government for allegedly withholding money from Florida to force it into expanding Medicaid.

Here are 10 things to know about the lawsuit and the dispute over the hospital funding.

1. Florida has had a Medicaid waiver since 2005, and the state has received between $1 billion and $2 billion from the federal government annually to support its Low Income Pool program to aid the state's safety-net hospitals.

2. In February, CMS announced it would not renew the Medicaid waiver, which is set to expire June 30. However, CMS said it would work with Florida to develop payment approaches for Florida's Medicaid beneficiaries.

3. Last week, CMS sent a letter to the Florida Agency for Health Care Administration suggesting that the fate of the state's Low Income Pool is tied to the state's decision on Medicaid expansion. "The state's expansion status is an important consideration in our approach regarding extending the LIP beyond June," wrote Vikki Wachino, acting director of CMS' Center for Medicaid and CHIP Services, in the letter to the FAHCA. "We believe that the future of the LIP, sufficient provider rates, and Medicaid expansion are linked in considering a solution for Florida's low income citizens, safety net providers and tax payers."

4. Justin Senior, deputy secretary for Medicaid at FAHCA, responded to CMS, warning the agency that tying the extension of LIP funding to Florida's Medicaid expansion status was illegal.

5. Gov. Scott also responded to CMS by threatening to sue the federal government — a plan he has now followed through with.

6. Gov. Scott announced the filing of the lawsuit shortly after the Florida House unilaterally ended its annual legislative session. The Florida House ended its session more than three days early after failing to resolve differences over the state budget and Medicaid expansion, according to the Miami Herald.

7. Florida Attorney General Pamela Jo Bondi and FAHCA joined Gov. Scott in filing the lawsuit against CMS, HHS Secretary Sylvia Burwell and Andy Slavitt, acting administrator of CMS. The lawsuit was filed in the U.S. District Court for the Northern District of Florida Pensacola Division.

8. "President Obama's sudden end to the Low Income Pool healthcare program to leverage us for Obamacare is illegal and a blatant overreach of executive power," Gov. Scott said in a statement, according to the Miami Herald. "His administration is effectively attempting to coerce Florida into Obamacare by ending an existing federal healthcare program and telling us to expand Medicaid instead. This sort of coercion tactic has already been called illegal by the U.S. Supreme Court."

9. The Supreme Court case Gov. Scott is referring to was cited by Mr. Senior in his letter to CMS. "In NFIB v. Sebelius…the U.S. Supreme Court explicitly warned the federal government against attempting to coerce states into participating in Medicaid expansion — yet that appears to be exactly what the federal government is attempting here," Mr. Senior wrote in the letter to Ms. Wachino.

10. Gov. Scott's lawsuit asks the court to prohibit the federal government from tying Florida's LIP program funding decision to the state's Medicaid expansion decision. The lawsuit also asks the court to compel the federal government to "immediately reconsider the renewal of Florida's LIP program without taking into consideration Florida's decision whether to opt into Medicaid expansion."

More articles on Medicaid expansion:

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