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Eleven days ahead of the state's special legislative session in which lawmakers are supposed to perform their most basic function — passing a friggin' budget, which they weren't able to do during the regular session — Governor Rick Scott sent a decree outlining what he hopes the session will accomplish.

Among this list of objectives is a provision aiming to bar talk of Medicaid expansion (he's good at making people not talk about stuff, isn't he?).

The State Senate is trying to get Scott and the State House to consider accepting billions in federal money to expand Medicaid, thereby providing affordable health coverage for hundreds of thousands of Floridians.

Making such a debate more urgent is the likely disappearance of federal low income pool dollars, which reimburses hospitals that care for the poor who go to the emergency room when they're really sick because they can't afford insurance that allows them to get routine checkups and other preventative care. Such hospitals include All Children's Hospital and Tampa General Hospital.

The loss of that funding, if expanding Medicaid is off the table, leaves a billion-dollar hole in the state budget. But now Medicaid expansion's opponents say they think the feds may be relenting on low income pool money.

That's because the U.S. Centers for Medicare and Medicaid Services, or CMS, sent a letter to the US Department of Health and Human Services outlining Florida's need for $1 billion to tide the state over while it transitions from the current funding model to, as the Tampa Bay Times' Steve Bousquet puts it, "new ways of compensating hospitals for the high cost of treating poor patients."

House Speaker Steve Crisafulli said in a written statement to other House members that his office is reviewing the letter for clues as to whether that means the state will actually get the LIP money after all, which might solve the current impasse and thwart the governor's threat of an impending government shutdown. He said he'll let everyone know once he gets clarification.

"Until then, I believe the clear indication before the Special Session is Florida will receive a significant level of LIP funds, which will help us in our efforts to finish the budget by the July 1 deadline," reads his statement.

Following news of the letter, Congresswoman Kathy Castor (D-Tampa) sent out a statement reminding the governor that, even if that funding comes through for another year, he's not off the hook.

“CMS made plain today that low-income pool monies paid for uncompensated care will be reduced substantially in future years due to the availability of health services through an expansion of Medicaid," Castor said in the statement. "This is a wake-up call to Gov. Rick Scott and Florida legislators that the transition must begin right away."

Most opponents of Medicaid expansion seem to have that position because they don't like President Obama (though we're pretty sure there are other motivations out there). Castor noted that the state got into this mess because Scott and House leadership decided to play chicken with the feds over something that's a life-or-death matter for about 800,000 Floridians.

“The Governor should take no solace in CMS agreeing to another transition period. In the end, CMS was urged to act because of Gov. Scott’s ideological plotting that would only hurt Florida neighbors; refusal to transition away from LIP, even though he knew for years this program was ending; and his ineptitude that once again left hospitals and the health of Floridians in the lurch. This is the final transition."



