Gov. Rick Scott's meeting Wednesday with the Obama administration's top health care official failed to resolve a funding standoff, prompting him to say he will prepare an emergency "base" budget to keep state government operating after June 30.
"We had a good conversation . . . but we don't have a resolution," Scott said after talking about an hour with Health and Human Services Secretary Sylvia Burwell about renewing a $2.2 billion hospital funding program.
HHS has told Florida the Low Income Pool, or LIP, is being phased out, and the government wants the state to expand Medicaid to cover an additional 800,000 uninsured residents.
The agency said Wednesday that Scott's alternative proposal "falls short."
The Republican governor's plan calls for distributing hospital money more broadly than to a few select hospitals. It would still, however, reward those hospitals that use local dollars to draw down matching money from the federal government.
It does not call for Florida to accept federal Medicaid expansion dollars, as the Florida Senate has proposed. "It's not going to happen," Scott told reporters before the trip to Washington.
Federal health officials said they "heard the governor's request for a timely response to help the state meet its budget deadline," but added that they wanted to wait until the public comment period in Florida ends on May 22 to render a final decision on the plan.
Asked why he waited until April 20 to submit a plan, Scott suggested it was HHS' fault. But HHS informed the state in July 2014 that the LIP would not be extended in current form beyond June 2015.
State Senate Democratic leader Arthenia Joyner of Tampa accused Scott of "rewriting history."
"The low-income families in our state haven't been waiting on the federal government, Gov. Scott, they've been waiting on you," she said in a statement.
The debate dominated the legislative session and contributed to an abrupt adjournment last week and no state budget for the fiscal year beginning July 1.
The Senate wants the Medicaid expansion, but the more conservative House has rejected that because the expansion is tied to Obamacare.
Legislators on Wednesday agreed to a special session running from June 1 to June 20.
"Now we're in a time crunch," Scott said, surrounded by reporters on a street corner near the federal health center. "If we don't have an answer our only solution is a base budget. That's what I'm working on now, to make sure that we keep government working."
Scott and Burwell's session had the potential to be awkward; the governor is suing her. Burwell is named as a defendant in Scott's recent suit alleging that the Obama administration is trying to force Florida into expanding Medicaid by ending the LIP program.
"The federal government shouldn't be trying to coerce us to expand Obamacare with an existing program at they started," Scott said Wednesday, echoing a theme of his lawsuit.
Critics quickly noted that the LIP program began when the state, then overseen by Gov. Jeb Bush, sought a waiver from the federal government.
During the meeting Burwell urged Scott to reconsider, "saying it is an important element to providing access to quality health care and reducing hospital costs that are typically passed on to taxpayers," according to a summary of the meeting provided by HHS.
"Regarding Medicaid expansion, Secretary Burwell reaffirmed that whether a state receives federal funding for an uncompensated care pool is not dependent on whether it expands Medicaid, and that the decision to expand Medicaid, or not, is a state decision," the statement read. "HHS has continuously worked with states interested in expanding Medicaid.
Scott once supported an expansion but came out against it this year.
"The expansion of Obamacare is not free," he said Wednesday, referring to the eventual costs the state would share in with the federal government. "If the federal government wants to have a program that they pay for, I won't stand in their way. . . . But don't come and tell me that you want to do something in my state and have me raise the taxes on my citizens."
Democrats blasted Scott as obstinate.
"Florida is not a corporation, it is a community, and Gov. Scott should govern accordingly," said U.S. Sen. Bill Nelson. "Right now he's showing a callous disregard for the needs of many of his fellow Floridians."
Ahead of his meeting with Burwell, Scott met with Fox News and the Wall Street Journal. He then flew home to attend a 6 p.m. ribbon cutting of a new medical center in Jupiter in Palm Beach County.
Jupiter Medical Center, a not-for-profit hospital, employs six lobbyists in Tallahassee, including former Senate President Ken Pruitt of Port St. Lucie. In his executive order Tuesday that created the Commission on Healthcare and Hospital Funding, Scott directed that the panel investigate "the extent to which taxpayer-funded hospitals pay for lobbyists, campaign contributions and advertising."
Times staff writer Steve Bousquet contributed to this report.