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According to U.S. Sen. Bill Nelson the Obama administration will not steer $1.3 billion toward helping Florida hospitals care for the uninsured. Nelson said officials with the federal Centers for Medicare and Medicaid (CMS) have communicated to him the Low Income Pool (LIP) money is not coming to Florida this year once it expires. The only federal alternative that would exist to Florida to support the low-income residents is expanding Medicaid. A now being faced by the 2015 Florida Legislature.

According to Nelson “I have spoken to the (Health and Human Services) Secretary Sylvia Burwell about this,” Nelson said, during a brief stop at his Tallahassee office. “And that is her position….The money is there under the law and…the federal government is not going to be paying twice.”

Senate President Andy Gardiner, R-Orlando, a hospital vice-president, has said the Senate will explore crafting a plan that could draw the $50 billion over the next decade the state would be eligible for if it expanded Medicaid.

The Senate Health Policy Committee has rolled out a 49-page bill it plans to review Tuesday that would create the Florida Health Insurance Affordability Exchange (FHIX). The proposal would provide private health insurance to about 800,000 Floridians, including individuals making up to $16,000 a year and families of four earning $33,000 annually.

Patients would pay monthly premiums of as much as $25 for coverage.

Gardiner sent a memo to senators in support of the plan — casting it as a way to expand coverage without relying on Medicaid, which many Republican lawmakers criticize.

“Some say Florida should not expand the existing Medicaid program, and I agree,” Gardiner said. “But we have the obligation to make coverage affordable and the opportunity to develop a consumer-driven approach — one that provides access to high-quality, affordable health care coverage while promoting personal responsibility.”

House Speaker Steve Crisafulli, R-Merritt Island, has said he has no interest in expanding Medicaid, which could be seen as buttressing the Affordable Care Act, President Barack Obama’s signature act condemned by most Republicans in Congress and in the state Legislature

Scott also has done nothing to try to sell the idea to resistant legislators since he voiced support two years ago for Medicaid expansion.

Now, however, the prospect of losing $1.3 billion in LIP is ratcheting up the conversation. If the cash vanishes, Gardiner has hinted it would derail state budget work and likely doom Scott’s push for a record-level of school spending and $673 million in tax cuts.

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