Attorneys general in 10 states, including Kansas, have asked a congressional committee to investigate efforts by the Obama administration to “coerce” states to expand their Medicaid programs by withholding unrelated healthcare funds.
In a statement Tuesday, Kansas Attorney General Derek Schmidt said he had joined the request, which comes after the Centers for Medicare and Medicaid Services (CMS) told Florida that it would withhold about $1 billion in federal funds for hospitals that serve the poor.
Florida sued the Obama administration in April, claiming the threat was aimed at coercing it into expanding its Medicaid program. The state said that was unconstitutional under a 2012 Supreme Court decision that upheld Obamacare but said that states couldn’t be forced to expand their Medicaid programs.
Kansas has filed a friend-of-the-court brief supporting Florida’s position.
Florida Gov. Rick Scott and the Florida legislature have opposed expanding Medicaid, which would extend health coverage to 800,000 low-income residents of the state.
“The Supreme Court said that it is up to the states to decide whether to expand their Medicaid programs,” Schmidt said in the statement. “The federal government may provide incentive for expansion, but it may not punish states for declining expansion by withdrawing unrelated financial support for other programs.”
Schmidt’s office could not immediately be reached for comment.
Florida and Kansas are among 21 states – Missouri is another – that have not expanded their Medicaid programs to 138 percent of the federal poverty level, as envisioned under the Affordable Care Act. That translates into a maximum of $16,105 for an individual and $32,913 for a family of four.
Florida and Kansas are also among states that get federal funding from the low-income pool, or LIP, a little-known program that supports hospitals and safety net providers who care for the uninsured. The Obama administration said more than a year ago that it was ending the program because it’s more efficient to give consumers insurance than reimbursing hospitals retroactively for their charity care.
Nonetheless, federal officials recently told Florida that it would receive about $1 billion under the program in the fiscal year beginning July 1.
The request by the attorneys general was contained in a letter to Rep. Fred Upton, chairman of the House Energy and Commerce Committee. The letter says that Kansas, Tennessee and Texas faced “similar threats regarding their uncompensated care pools and are experiencing increasing pressure from CMS to expand Medicaid in exchange for continued funding” under LIP.
It goes on to say that, while CMS has discretion to approve LIP programs, it “cannot make its determination based on a state’s opting-out of Medicaid expansion.”
Also signing the letter were the attorneys general of Alabama, Florida, Georgia, Idaho Louisiana, Nebraska, South Carolina and Utah.
Dan Margolies, editor of the Heartland Health Monitor team, is based at KCUR.
