Administration bears down on states to expand Medicaid

Jim Nathan, CEO of Fort Myers, Fla.-based Lee Memorial Health System, is watching his state's ferocious political battle over Medicaid expansion with growing concern. The stakes are high for his system's three hospitals.

Under a federal Medicaid waiver that expires in June, Florida receives between $1 billion and $2 billion annually to help its safety net providers with uncompensated-care costs. The Obama administration recently made clear that it's tying possible renewal of the funding to the state expanding Medicaid coverage to nearly 800,000 adult residents with incomes up to 138% of the federal poverty level. Florida's Republican-led Senate supports the administration's position, while Gov. Rick Scott and the GOP-led House oppose it. 

The CMS has delivered the same message to other non-expansion states that receive similar Medicaid supplemental funding, including KansasTennessee andTexas, detailing criteria for receiving continued dollars. It also contacted five other states, including Arizona and California, that receive such funding and have already expanded Medicaid.

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