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Florida — which is already among a handful of states trying to
derail the federal health care overhaul — may ask for a waiver so it
does not have to comply with some provisions dealing with the state’s
safety net program for the poor.

Attorney General Bill McCollum has already filed a lawsuit challenging the legality of the health care overhaul. But incoming Senate President Mike Haridopolos said in an interview with Newsmax that he wants to submit a waiver to the federal Centers for Medicare and Medicaid Services so Florida can have “flexibility" in how it deals with Medicaid.

Haridopolos makes clear that the state can’t “opt out” of the
Affordable Care Act but he said the state can’t afford to implement the
expansions of Medicaid required by the federal law.

Under the health care overhaul Floridians earning 133 percent of the
federal poverty level would be eligible for the program that pays the
health care needs for the poor and disabled. Under the 2010 poverty
guidelines 133 percent of the poverty level equals $29,326.50 for a
family of four.

The federal government would pay the majority of those costs for the
expansion initially but eventually would pare back how much it pays and
put more of the burden on the state.

Florida’s Medicaid budget is currently $20 billion and serves about
2.9 million people. Under federal health care reform, Haridopolos
predicted enrollment in the program would balloon up to 4.4 million
Floridians.

“Everybody knows who studies politics that Medicaid is the most
broken system in government and what do they do? They expanded it by
almost 50 percent. We can’t afford it and that’s why we are asking for a
waiver. We need flexibility as a state to administer it to meet state
needs.

“All we want is flexibility and we want to have the ability to meet
peoples’ needs, give them access to care,” Haridopolos said. "But the
one size fits all agenda that is coming out of Washington is untenable.
It doesn’t work and history has proven that over and over again." 

Haridopolos’ remarks were met with criticism from incoming Senate Democratic Leader Nan Rich,
D-Weston, who said that the Senate president should be focusing his
efforts on providing Floridians access to health care not finding ways
to circumvent the federal health care overhaul.

Rich also predicted that the Centers for Medicare and Medicaid Services would not approve any waiver request.

“I think instead of focusing time on political tactics that won’t be
granted we should focus our time on figuring out the solutions,” she
said.

A Medicaid waiver must be submitted by the agency with oversight of the Medicaid program which is the Agency for Health Care Administration. Before AHCA submits a waiver it must first receive legislative approval.

AHCA already asked the federal government to extend its 1115 Medicaid
waiver. CMS denied the request to extend the waiver but in a letter
said it will consider renewing it. Rich questioned whether the super
waiver would be at odds with an 1115 waiver.

The 1115 waiver is what makes the Medicaid Reform project in five
Florida counties operational as well as a $1 billion pot of money used
to finance the Medicaid program called the Low Income Pool.

“It may create a conflict,” Rich said of a request for a super waiver.

Originally published in the Florida Current – exclusively distributed via Lobbytools – Florida’s Premiere Legislative and Media Monitoring Service.