From: Crisafulli, Steve Sent: Tuesday, April 28, 2015 1:16 PM To: Crisafulli, Steve Subject: Sine Die To: Members of the Florida House of Representatives From: House Speaker Steve Crisafulli Re: Sine Die As a follow up to the Sine Die announcement made on the floor, I wanted to provide you with a few documents. Please see the latest response to the Senate on their Friday response to the Florida House. Also attached are my remarks on the floor, as well as an opinion editorial which outlines the House position on Medicaid expansion, the Low Income Pool, and our constitutional duty to pass a balanced state budget. At this time, I do not have information on when we will be back in Tallahassee for a Special Session. I understand the uncertainty creates difficulties for your family and work schedules. I am committed to doing everything I can within our principles to get us into conference. Our office will continue to provide you with information and updates in a timely manner. Thank you for your patience. I look forward to coming back to complete our work as soon as possible.
As of Conclusion of Day 56, 2015 Regular Session 871 House Bills Filed 880 Senate Bills Filed 268 House Bills Passed House 83 House Bills Passed both Chambers 177 Senate Bills Passed Senate 61 Senate Bills Passed both Chambers 140 Bills Passed Both Chambers and Sent to Governor* 81 House Bills to Governor 59 Senate Bills to Governor House in Session: 63 hours and 56 minutes in 20 days Senate in Session: 39 hours and 1 minute in 11 days
House Response to Senate Response #2 At this time, we are at an unfortunate impasse. It s our understanding from the Senate responses that you would prefer to wait on allocation decisions until the House expands Medicaid, or until CMS provides us with sufficient funds in response to our LIP waiver request. We stand ready to work with you to mitigate negative impacts on the State should the federal government fail to provide Florida adequate Low Income Pool funding. We do not think it s necessary to delay the budget while we wait on CMS, particularly when the House has offered significant movement by providing budget contingency plans. However, we recognize that the House and Senate are equal partners when it comes to the budget. Therefore, we believe our best course of action is to conclude our policy business for the 2015 Regular Legislative Session. Today, we will Sine Die and return at a time when the House and Senate can agree on allocations, which are fundamental to building the budget. The House and Senate have come together on significant policy issues this Session and I am confident we will be able to return and finish our constitutional duty to pass a balanced budget.
Why Medicaid Expansion Does Not Work For Florida Submitted by House Speaker Steve Crisafulli Word Count: 744 In 2012, the U.S. Supreme Court gave states the option to expand Medicaid under ObamaCare and Florida has chosen not to expand. There are principled reasons for declining to grow a program that currently covers 3.7 million Floridians at a cost of $23.5 billion per year, or about one-third of Florida s budget. We oppose expanding Medicaid because it is a broken system with poor health outcomes, high inflation, unseverable federal strings, and no incentive for personal responsibility for those who are able to provide for themselves. Under current law, Florida provides for our most vulnerable: low-income children, pregnant women, the elderly and disabled people. Under federal law, other low-income Floridians have access to healthcare subsidies to buy private insurance for less than the average cost of a wireless phone bill. In fact, if we choose ObamaCare expansion, 600,000 will lose eligibility for their subsidies, of which 257,000 would be forced into Medicaid. Those who claim we should expand Medicaid to get Florida s money back should note that we already receive over $15 billion more each year than we send to Washington. It s deficit spending. The national debt burden today is $145,000 per household. Medicaid expansion would not be financed with the hard-earned dollars we have already sent to Washington - it would be financed by mortgaging our children s and grandchildren s future. The Florida Senate disagrees and has unfortunately partnered with the Obama Administration to demand Medicaid expansion. They suggest existing safety-net funding (the Low-Income Pool, or LIP) and our state budget are tied to federal healthcare policy goals. What is LIP? It s a federal program that provides $1.3 billion to hospitals and other providers, using additional local matching dollars. It was approved in 2006 to replace a prior program, in place for decades. Last year, the federal government told us that LIP needs to end in its current form, yet gave no guidance about what a new program should look like. Florida entered into talks with the federal government. Months later, the state was suddenly told that continued LIP funding is linked to Medicaid expansion. The implication is that if we don t expand, we won t get LIP funds. Eliminating LIP has serious consequences for some Florida hospitals and primary care programs. The federal government should approve a new program. If that does not happen, we need to take a serious look at what hospitals really need from taxpayers and whether hospitals can be more prudent and efficient.
If we lose the federal LIP funds, we can create a more limited, state-funded program or we can live without LIP by pursuing other policy options aimed at reducing costs and increasing access to quality healthcare. Such options include ideas that the Florida House has championed for years. We support expanding the use of telemedicine and expanding the scope of practice for advance practice nurses to treat patients. We support encouraging direct primary care, which restores the doctor/patient relationship so healthcare is available at dramatically lower costs. We support expanding medical malpractice reform to reduce frivolous lawsuits that increase healthcare costs, and expanding choices for where patients get their healthcare by eliminating unnecessary government regulations. We support breaking geographic monopolies for hospitals. We support allowing consumers to buy health insurance across state lines. The LIP experience points to the difficulty of working with an unreliable, unpredictable federal partner more committed to a political goal than good government. I am hopeful the LIP negotiations will move past the Medicaid expansion debate to bring a swift resolution that creates a reasonable hospitalfunding program. In the meantime, the best course for Florida is to separate Medicaid expansion discussions and finish our state budget. Manufacturing a budget crisis in order to leverage a federal policy preference is not in the best interest of 19 million Floridians who are counting on us to do our job. Florida s safety-net population and budget should not suffer because we disagree with the federal government on healthcare policy. We must have a budget by July 1, and the Florida House of Representatives stands ready to meet our constitutional obligation. The House made multiple offers to the Senate to restart the stalled budget process that would set aside state moneys as a contingency fund for our safety net pending the outcome of the talks with the federal government. Our offer still stands. I believe we can responsibly craft a budget and together move toward common ground policy ideas that are in the best interest of all Floridians.
Members: I want to take a moment and update you on where we stand on budget negotiations with the Senate. First off, thank you for your patience as we have worked through an incredibly unusual Session. Never before has the budget come to a total standstill over a policy difference between the two chambers. I understand and respect that the House and Senate have a difference of opinion on Medicaid expansion and LIP funding. And so, recognizing that this is a process based on two equal legislative partners, the House made genuine and legitimate offers which demonstrate a willingness to address some of the Senate s stated positions. However, the Senate continues to assert their demand that we agree to expand Medicaid before we can start budget negotiations. Keep in mind, they did not say they would hold the budget hostage before we started. It s clear that this has become a position important to the Senate President, but he never told me it was going to be a prerequisite for budget negotiations. The Senate had no House bill sponsor for their bill in fact, not a single Republican or Democrat member filed any expansion bills. The Senate s Medicaid expansion bill has been sitting on their calendar since March.
And the Senate bill literally cannot be implemented as written. We don t call that negotiating where I come from. Members, I made a promise when you elected me as your Speaker that I would never ask you to vote for something that I would not vote for myself. Accordingly, I will not force anyone to expand Medicaid. And so, for now, we stand at an impasse. With more time and more information, it is possible that the Senate will be in a better position to accomplish allocations. As President Lee stated yesterday, there is no possible hope of getting into conference at this time. I am proud of what this Chamber HAS accomplished with Republicans AND Democrats working together for Florida on issues like: A balanced budget. Tax cuts for families and businesses. Comprehensive Water policy. A transparent structure for Amendment 1 funding. Education reforms to reduce testing, lower tuition, and improve our schools. Promoting and incentivizing adoptions. Reforming local pensions. Department of Corrections reform And yes, we even passed issues that were identified by Senate President Gardiner as his personal priorities by finding ways to help give persons with disabilities new opportunities for education and job training.
No, we did not pass everything we wanted. And we won t get everything we hoped for But we have done all we can for this Session. I do not see a need to keep all of you here waiting around away from your families and your businesses until the Senate decides they are ready to negotiate. And so, having accomplished all we can do, it s time to go home. I will communicate with you as soon as we have a more realistic path for getting into budget conference. I believe that a reset and a clean slate is the best way for us to accomplish that goal. With that, I would like to recognize Chair Corcoran for a motion.