New issues in indigent health care funding for Manatee County

Add another wrinkle to Manatee County's ongoing challenge with partially funding health care for the working poor. As county officials, the medical community and other stakeholders wrestle up a strategy to lower costs and improve outcomes, federal dollars are shrinking just as Manatee's trust fund is evaporating. The new county budget backfills that gap with almost $7 million out of reserves.

Last year, the federal government handed Florida more than $2 billion to help hospitals with unpaid bills for indigent health care. This year the Low Income Pool program fell to $1 billion, and the Legislature came up with $400 million to plug part of the hole.

The U.S. Centers for Medicare and Medicaid announced last week the agency would hold firm to a cap of $608 million next year, an amount causing angst among safety-net hospitals statewide. The Tampa Bay Times reported this week that state lawmakers are balking at once again buttressing LIP, but the next state budget is a long way from being written.

Should the Legislature reject funding, Manatee County's share of LIP dollars would surely fall. That would exacerbate a dire situation.

Florida could easily solve this vexing problem by accepting the federal offer of billions in aid if the state accepts an expansion of Medicaid to more working poor as part of the Affordable Care Act. LIP is being phased out under the assumption that all states would expand the program but some haven't.

Many working poor reside in the gap between ACA policies and old Medicaid income guidelines. Florida's House has been blocking Medicaid expansion on purely political terms that hold no water. Manatee County, as elsewhere in Florida, is paying the price. Shame on the House, especially if lawmakers do slash funding for LIP.

This story was originally published October 24, 2015 at 12:00 AM with the headline "New issues in indigent health care funding for Manatee County ."