Rep. Brown: 'UF Health will not close on my watch'

Congresswoman says she is forming plan to save LIP funding, UF Health

JACKSONVILLE, Fla. – Flanked by supporters and local Democratic representatives, U.S. Rep. Corrine Brown joined others Monday morning outside UF Health Jacksonville to say there's no way she will let the medical center shut down in a dispute between the state and federal government over funding of indigent care.

Brown, Rep. Mia Jones, local ministers and community leaders declared their strident opposition to Gov. Rick Scott's refusal to accept Medicaid dollars or negotiate with HHS, which could result in the loss of $1.3 billion in funding to Florida hospitals that serve indigent patients.

"It is abundantly clear that Florida Gov. Rick Scott and the Florida House Republicans fighting against providing health insurance coverage to those currently uninsured are completely indifferent to the suffering of their constituents," Brown said.

Brown said she is working on a plan to save UF Health in case there is no agreement between state and federal governments over so-called low-income pool funding.

Scott said Thursday he would sue the Obama administration for withholding hospital funds because the state won't expand Medicaid.

The fight over LIP funding has come to a head as the state Legislature is desperate for an answer from the feds so it can finalize a state budget before July 1.

Scott contends that a 2012 U.S. Supreme Court decision bars the federal government from coercing states into expanding Medicaid. Yet, that's what the Republican governor says the Centers for Medicare and Medicaid Services is doing because the agency insists that the hospital funds and Medicaid expansion should be part of the same discussion.

"It is appalling that President Obama would cut off federal health care dollars to Florida in an effort to force our state further into Obamacare," Scott said in a statement.

The federal-state fight has spilled over to the Florida Legislature where the House and Senate remain gridlocked with rival budgets $4 billion apart. The House is refusing to expand Medicaid and the Senate vows it will not pass a budget that includes deep cuts to hospitals.

"That we finds ourselves in this position, when the feds distinctly told the administration more than a year ago that the LIP demonstration project would not be funded in the same manner, is indicative of a lack of leadership and constant turnover in the Agency for Healthcare Administration," Sen. Audrey Gibson, D-Jacksonville, said in a statement Monday. 

Meanwhile, state hospitals, including UF Health, said they're doomed without the hospital funds and advocates have rallied lawmakers almost daily saying the political bickering is jeopardizing the health of real citizens.

UF Health CEO Russ Armistead told News4Jax that his hospital has $95 million in LIP funding. He said there's a good chance the area's only Trauma One Critical Care center would close if the funding is not renewed.

"If that happens, I'm out of money," Armistead said last week. "We are not alone. The 14 safety-net hospitals in Florida are at the same position as us, but they tend to have more financial reserves than we do, so we would be the first to experience a loss of cash. I would have the equivalent of six months of cash."

Federal health officials have not commented on Scott's lawsuit, but have previously said that Florida is free to make its own choice regarding Medicaid expansion. The feds have said they want Medicaid expansion to be part of the solution in the debate over hospital funds.

They also want the state to prove how relying on federal funds to pay hospitals caring for those without insurance is more effective use of taxpayer money than purchasing health insurance directly for those patients.

Scott, who campaigned against Obama's health law, recently reversed course, saying he no longer supports Medicaid expansion.

The governor said Obama's health care law "also threatens poor families' access to the safety net health care services they need."

The Senate has proposed a compromise that would forgo Medicaid expansion and give billions in federal funds to consumers to purchase private health insurance for themselves. Recipients would be required to hold a job or go to school and contribute a small amount. Scott and the House are against it, warning the federal government can't be trusted to foot the bill.

The Obama administration has promised to never pay less than 90 percent of the cost.
"Our democracy is designed so that state governments can make the decision to not take on federal programs that will ultimately cost state taxpayers billions of dollars," Scott said in the release. "We will not pass this cost on to our citizens in Florida and we will continue to fight for the federal LIP dollars our citizens already pay for with their federal taxes."

Armistead said the issue was resolved at the last minute last year, and similar issues arose the three years before that. But this year, more money is at stake.

"Because we go through it every year, it's fair to say it's frustrating," Armistead said. "I think it's also frustrating for our legislators. They are elected, trying to do the right thing.
"If the federal government doesn't match the money (and) the state doesn't match it, I'm out of business," Armistead said. "If the state matches it, they don't have money for other programs. It's a very difficult spot to be in."

Armistead said that other hospitals that aren't equipped for it would have to treat the influx of patients who typically would go to UF Health, causing slower treatment times.

Last month, Armistead was joined by other local business leaders at the hospital to call on state legislators to find a way to keep the funding in place so that hospitals don't suffer.

Thurday, Arthenia Joyner, the Senate Democratic Leader, said the move by Scott is just grandstanding and not focusing on the real issue.

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