Tensions erupt in House over DeSantis-backed Hope Florida program's $10M windfall
For two hours Tuesday, a panel of House lawmakers asked pointed questions of leaders for the state's main health care administration agency.
Rep. Alex Andrade, who chairs the House Health Care Budget Subcommittee, didn't like the answers.
'I'm more stunned, than anything else, by the responses, the demeanor, the flippancy (toward) the serious questions we have,' Andrade, R-Pensacola, told reporters after the hearing. 'This is an endemic problem in state agencies right now and it's something that we've got to work on.'
Shevaun Harris, the secretary of the Agency for Health Care Administration, had struggled to answer questions on a series of issues related to Hope Florida, a program spearheaded by First Lady Casey DeSantis that tries to connect Floridians receiving welfare and Medicaid with other services to help move them off government assistance.
Andrade and other members of the panel expressed alarm over $10 million that went to the Hope Florida Foundation as part of a settlement between AHCA and Centene, a large provider of services under Florida's Medicaid managed care plans.
Under state law, money from settlements must be reported by state agencies to the Legislature, but this wasn't.
As Harris explained, the overall settlement was $67 million, with $57 million going to AHCA. It had to do with overpayments related to pharmacy benefit managers, she said, but the other $10 million was a donation from Centene to the Hope Florida Foundation, so the money never came to AHCA and was therefore was not state funds reportable to the Legislature.
The settlement was reached in October; Harris didn't take the helm at AHCA until February. 'The settlement agreement had a lot of attorneys involved, taking great care to make sure everything was done appropriately,' she said.
But Andrade, an attorney, maintains the funds are taxpayer money and the settlement violates state law: 'The reference to that $10 million not being taxpayer dollars I find offensive,' Andrade said at one point in the hearing.
He noted the settlement was for repaying overpayments from the state's Medicaid program. 'At what point did it suddenly become not taxpayer money?' asked Andrade, a state representative since 2018.
Andrade also raised concerns about Hope Florida getting preferential treatment in the state's Medicaid Managed Care contracts. Specifically, health care insurers must cooperate with Hope Florida as part of the contract.
Another gripe from the committee was the alleged lack of transparency surrounding Hope Florida.
'I still don't get a clear response over who is responsible for Hope Florida,' said Rep. Marie Woodson, D-Hollywood. 'We need to have some names.'
Harris explained that the Hope Florida program uses state employees at many different agencies to help connect those in need with services throughout state government and with nonprofits, including churches, who can provide food, clothing and shelter for those in crisis.
That means there is no executive director of the Hope Florida program, she added.
But the Hope Florida Foundation, which is a nonprofit, is a separate entity. She said that group has a board and later in the hearing said its chairman is Josh Hay, CEO of Indelible Solutions, a Tallahassee-based management consulting firm.
As a nonprofit, the Hope Florida Foundation is required to file tax forms with the IRS that are required to be made available upon request by members of the public, but reporters from the Miami Herald/Tampa Bay Times Tallahassee Bureau have said they were turned away after making such a request at the Department of Children and Families headquarters in the capital.
The heightened scrutiny of Hope Florida comes as Casey DeSantis is said to be considering a run for governor in 2026 to replace her husband, Gov. Ron DeSantis, who is term-limited. DeSantis has pushed lawmakers to codify Hope Florida, which was started by Casey DeSantis in 2021, into law.
At one point in the hearing, Harris said the Hope Florida program was simply trying to help those in need and implied lawmakers weren't sharing that goal.
'I'm not sure why we're here," Harris said. "And I understand there are questions being asked and we're doing our best to be transparent to answer but it does feel like we're not aligned in this overall goal of helping families.
'It's kind of sad, genuinely," she added. "This is the goal of helping individuals get back on their feet. I don't know what's wrong with that.'
'I'm going to take umbrage at that claim,' Andrade replied. 'We're a separate government body tasked with oversight and direction of state agencies and we discover that state agencies are redirecting money secretly, at the eleventh hour, in a legal settlement without giving us any notice? And the accusation is that we don't care about helping Florida families? I take personal issue at that insinuation, Secretary.'
Gray Rohrer is a reporter with the USA TODAY Network-Florida Capital Bureau. He can be reached at grohrer@gannett.com. Follow him on X: @GrayRohrer.
This article originally appeared on Tallahassee Democrat: Hope Florida under fire for lack of oversight, $10M settlement
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Medscape
an hour ago
- Medscape
Federal Proposals Threaten Provider Taxes
Republican efforts to restrict taxes on hospitals, health plans, and other providers that states use to help fund their Medicaid programs could strip them of tens of billions of dollars. The move could shrink access to healthcare for some of the nation's poorest and most vulnerable people, warn analysts, patient advocates, and democratic political leaders. No state has more to lose than California, whose Medicaid program, called Medi-Cal, covers nearly 15 million residents with low incomes and disabilities. That's twice as many as New York and three times as many as Texas. A proposed rule by the Centers for Medicare & Medicaid Services, echoed in the Republican House reconciliation bill as well as a more drastic Senate bill, would significantly curtail the federal dollars many states draw in matching funds from what are known as provider taxes. Although it's unclear how much states could lose, the revenue up for grabs is big. For instance, California has netted an estimated $8.8 billion this fiscal year from its tax on managed care plans and took in about $5.9 billion last year from hospitals. California Democrats are already facing a $12 billion deficit, and they have drawn political fire for scaling back some key healthcare policies, including full Medi-Cal coverage for immigrants without permanent legal status. And a loss of provider tax revenue could add billions to the current deficit, forcing state lawmakers to make even more unpopular cuts to Medi-Cal benefits. 'If Republicans move this extreme MAGA proposal forward, millions will lose coverage, hospitals will close, and safety nets could collapse under the weight,' Gov. Gavin Newsom, a Democrat, said in a statement, referring to President Donald Trump's 'Make America Great Again' movement. The proposals are also a threat to Proposition 35, a ballot initiative California voters approved last November to make permanent the tax on managed care organizations, or MCOs, and dedicate some of its proceeds to raise the pay of doctors and other providers who treat Medi-Cal patients. All states except Alaska have at least one provider tax on managed care plans, hospitals, nursing homes, emergency ground transportation, or other types of healthcare businesses. The federal government spends billions of dollars a year matching these taxes, which generally lead to more money for providers, helping them balance lower Medicaid reimbursement rates while allowing states to protect against economic downturns and budget constraints. New York, Massachusetts, and Michigan would also be among the states hit hard by Republicans' drive to scale back provider taxes, which allow states to boost their share of Medicaid spending to receive increased federal Medicaid funds. In a May 12 statement announcing its proposed rule, CMS described a 'loophole' as 'money laundering,' and said California had financed coverage for over 1.6 million 'illegal immigrants' with the proceeds from its MCO tax. CMS said its proposal would save more than $30 billion over 5 years. 'This proposed rule stops the shell game and ensures federal Medicaid dollars go where they're needed most — to pay for healthcare for vulnerable Americans who rely on this program, not to plug state budget holes or bankroll benefits for noncitizens,' Mehmet Oz, the CMS administrator, said in the statement. Medicaid allows coverage for noncitizens who are legally present and have been in the country for at least 5 years. And California uses state money to pay for almost all of the Medi-Cal coverage for immigrants who are not in the country legally. California, New York, Michigan, and Massachusetts together account for more than 95% of the 'federal taxpayer losses' from the loophole in provider taxes, CMS said. But nearly every state would feel some impact, especially under the provisions in the reconciliation bill, which are more restrictive than the CMS proposal. None of it is a done deal. The CMS proposal, published May 15, has not been adopted yet, while the House and Senate bills must be negotiated into one and passed by both chambers of Congress. But the restrictions being contemplated would be far-reaching. A report by Michigan's Department of Health and Human Services, ordered by Democratic Gov. Gretchen Whitmer, found that a reduction of revenue from the state's hospital tax could 'destabilize hospital finances, particularly in rural and safety-net facilities, and increase the risk of service cuts or closures.' Losing revenue from the state's MCO tax 'would likely require substantial cuts, tax increases, or reductions in coverage and access to care,' it said. CMS declined to respond to questions about its proposed rule. The Republicans' House-passed reconciliation bill, though not the CMS proposal, also prohibits any new provider taxes or increases to existing ones. The Senate version, released on June 16, would gradually reduce the allowable amount of many provider taxes. The American Hospital Association, which represents nearly 5000 hospitals and health systems nationwide, said the proposed moratorium on new or increased provider taxes could force states 'to make significant cuts to Medicaid to balance their budgets, including reducing eligibility, eliminating or limiting benefits, and reducing already low payment rates for providers.' Because provider taxes draw matching federal dollars, Washington has a say in how they are implemented. And the Republicans who run the federal government are looking to spend far fewer of those dollars. In California, the insurers that pay the MCO tax are reimbursed for the portion levied on their Medi-Cal enrollment. That helps explain why the tax rate on Medi-Cal enrollment is sharply higher than on commercial enrollment. Over 99% of the tax money the insurers pay comes from their Medi-Cal business, which means most of the state's insurers get back almost all the tax they pay. That imbalance, which CMS describes as a loophole, is one of the main things Republicans are trying to change. If either the CMS rule or the corresponding provisions in the House reconciliation bill were enacted, states would be required to levy provider taxes equally on Medicaid and commercial business to draw federal dollars. California would likely be unable to raise the commercial rates to the level of the Medi-Cal ones because state law constrains the legislature's ability to do so. The only way to comply with the rule would be to lower the tax rate on Medi-Cal enrollment, which would sharply reduce revenue. CMS has warned California and other states for years, including under the Biden administration, that it was considering significant changes to MCO and other provider taxes. Those warnings were never realized. But the risk may be greater this time, some observers say, because the effort to shrink provider taxes is embedded in both Republican reconciliation bills and intertwined with a broader Republican strategy — and set of proposals — to cut Medicaid spending by $800 billion or more. 'All of these proposals move in the same direction: Fewer people enrolled, less generous Medicaid programs over time,' said Edwin Park, a research professor at Georgetown University's McCourt School of Public Policy. California's MCO tax is expected to net California $13.9 billion over the next two fiscal years, according to January estimates. The state's hospital tax is expected to bring in an estimated $9 billion this year, up sharply from last year, according to the Department of Health Care Services, which runs Medi-Cal. Losing a significant slice of that revenue on top of other Medicaid cuts in the House reconciliation bill 'all adds up to be potentially a super serious impact on Medi-Cal and the California state budget overall,' said Kayla Kitson, a senior policy fellow at the California Budget & Policy Center. And it's not only California that will feel the pain. 'All states are going to be hurt by this,' Park said.
CNN
7 hours ago
- CNN
Senate GOP at odds over Medicaid, other sticking points in Trump megabill amid push for vote this week
Republican senators left a Monday evening meeting pointing to several key outstanding issues that must be addressed in their sweeping domestic policy bill as Congress closes in on the July 4th recess, raising questions about whether the Senate can finish it by the end of the week. GOP leadership has been bullish it's still on track to bring to the floor this week, but no final decisions on the most contentious issues were solidified in the meeting, senators said. In particular, senators pointed to remaining concerns about rural hospitals amid changes to Medicaid's provider tax provision, as well as the state and local tax policy – a key sticking point with several House Republicans. Sen. Josh Hawley of Missouri, who has been vocal in his support for protecting rural hospitals, said that they are still sorting out a potential provider fund option to bolster medical facilities, noting he would like to see at least $100 billion in the fund. 'I don't know if it's enough, but that's a very good start,' he said, noting: 'We don't have any details at all. They did not commit to that number, or any number.' 'They need to work this out. They need to address the rural hospitals' concerns, and I think if that happens, then this bill will pass here and in the House,' he added. 'It's all a work in progress.' Sen. Markwayne Mullin of Oklahoma, who has been the key go-between for GOP senators and House Republicans on the issue of state and local taxes, or SALT, noted that he had floated a potential solution to senators at the meeting – though he acknowledged that neither side will be truly happy with it. A key block of House Republicans from New York and California have been pushing to retain the state and local tax provisions from the House bill, an idea that most GOP senators consider a non-starter. Mullin said that he is going to speak with those House members Monday night about the idea of keeping the cap at the House-passed $40,000, while lowering the income threshold of who would apply. 'I think we're in a spot that neither side is going to love, but we're in a spot,' he said. 'I think we got our numbers now.' Mullin insisted his proposal 'is not going to lose any votes,' on the Senate side, 'but, as I said, it's not a joyful spot for any of us to be in.' Sen. John Cornyn of Texas, told reporters that the main purpose of the meeting was for various committee chairmen to present what provisions of the bill had fallen out during the so-called Byrd bath, a wonky process that involves working with the Senate parliamentarian to ensure their proposals pass muster with the chamber's byzantine budget rules. The critical review allows Republicans to move the bill with a simple majority. Sen. John Boozman, who chairs the Senate Agriculture Committee and had several key provisions fall out of the bill after his section was scrubbed, said that they are proposing some changes to their language to appease the parliamentarian. In particular, they are extending the times states need to implement changes to the Supplemental Nutrition Assistance Program, or SNAP, as food stamps are formally known. 'What we're trying to do is give the states more time to understand what they're dealing with, so that they can respond,' he said, explaining the solution is nuanced. 'We have good reason to believe that if we make some changes, that we can make it Byrd compliant.' Boozman added that Senate Majority Leader John Thune is taking this and other proposed changes to the bill post-Byrd bath and trying to get the parliamentarian to agree to let them back in the package. Mullin also noted that this process is underway. 'I think a lot of our chairs were trying to rewrite it, to where it would fall inside of that [Byrd rule]. As they were saying, 'adjust the dials' – everybody hates that term, but that seems like to be the most common term – and get into a good landing spot,' said Mullin. Congressional leadership has been saying since May that they want this package to pass the Senate and the House by the self-imposed deadline of July 4, and the clock is ticking with so much left to sort out. 'We're on schedule,' Thune told CNN earlier Monday. Thune argued that the process of scrubbing the bill to ensure it complies with Senate rules is a process they don't have 'complete control over,' but that 'they're working through it, and in some cases, as things are flagged, we're making counter offers.' Pressed on whether he would have the needed GOP support to vote this week given the wide range of concerns and outstanding issues, Thune simply said: 'Let's hope so.' Sen. John Kennedy told reporters Monday evening that he didn't know whether a vote would take place this week. 'Right now, the bill is held together with happy thoughts and spit. I think we'll eventually pass something, I just can't tell you when,' he said.
CNN
7 hours ago
- CNN
Senate GOP at odds over Medicaid, other sticking points in Trump megabill amid push for vote this week
Republican senators left a Monday evening meeting pointing to several key outstanding issues that must be addressed in their sweeping domestic policy bill as Congress closes in on the July 4th recess, raising questions about whether the Senate can finish it by the end of the week. GOP leadership has been bullish it's still on track to bring to the floor this week, but no final decisions on the most contentious issues were solidified in the meeting, senators said. In particular, senators pointed to remaining concerns about rural hospitals amid changes to Medicaid's provider tax provision, as well as the state and local tax policy – a key sticking point with several House Republicans. Sen. Josh Hawley of Missouri, who has been vocal in his support for protecting rural hospitals, said that they are still sorting out a potential provider fund option to bolster medical facilities, noting he would like to see at least $100 billion in the fund. 'I don't know if it's enough, but that's a very good start,' he said, noting: 'We don't have any details at all. They did not commit to that number, or any number.' 'They need to work this out. They need to address the rural hospitals' concerns, and I think if that happens, then this bill will pass here and in the House,' he added. 'It's all a work in progress.' Sen. Markwayne Mullin of Oklahoma, who has been the key go-between for GOP senators and House Republicans on the issue of state and local taxes, or SALT, noted that he had floated a potential solution to senators at the meeting – though he acknowledged that neither side will be truly happy with it. A key block of House Republicans from New York and California have been pushing to retain the state and local tax provisions from the House bill, an idea that most GOP senators consider a non-starter. Mullin said that he is going to speak with those House members Monday night about the idea of keeping the cap at the House-passed $40,000, while lowering the income threshold of who would apply. 'I think we're in a spot that neither side is going to love, but we're in a spot,' he said. 'I think we got our numbers now.' Mullin insisted his proposal 'is not going to lose any votes,' on the Senate side, 'but, as I said, it's not a joyful spot for any of us to be in.' Sen. John Cornyn of Texas, told reporters that the main purpose of the meeting was for various committee chairmen to present what provisions of the bill had fallen out during the so-called Byrd bath, a wonky process that involves working with the Senate parliamentarian to ensure their proposals pass muster with the chamber's byzantine budget rules. The critical review allows Republicans to move the bill with a simple majority. Sen. John Boozman, who chairs the Senate Agriculture Committee and had several key provisions fall out of the bill after his section was scrubbed, said that they are proposing some changes to their language to appease the parliamentarian. In particular, they are extending the times states need to implement changes to the Supplemental Nutrition Assistance Program, or SNAP, as food stamps are formally known. 'What we're trying to do is give the states more time to understand what they're dealing with, so that they can respond,' he said, explaining the solution is nuanced. 'We have good reason to believe that if we make some changes, that we can make it Byrd compliant.' Boozman added that Senate Majority Leader John Thune is taking this and other proposed changes to the bill post-Byrd bath and trying to get the parliamentarian to agree to let them back in the package. Mullin also noted that this process is underway. 'I think a lot of our chairs were trying to rewrite it, to where it would fall inside of that [Byrd rule]. As they were saying, 'adjust the dials' – everybody hates that term, but that seems like to be the most common term – and get into a good landing spot,' said Mullin. Congressional leadership has been saying since May that they want this package to pass the Senate and the House by the self-imposed deadline of July 4, and the clock is ticking with so much left to sort out. 'We're on schedule,' Thune told CNN earlier Monday. Thune argued that the process of scrubbing the bill to ensure it complies with Senate rules is a process they don't have 'complete control over,' but that 'they're working through it, and in some cases, as things are flagged, we're making counter offers.' Pressed on whether he would have the needed GOP support to vote this week given the wide range of concerns and outstanding issues, Thune simply said: 'Let's hope so.' Sen. John Kennedy told reporters Monday evening that he didn't know whether a vote would take place this week. 'Right now, the bill is held together with happy thoughts and spit. I think we'll eventually pass something, I just can't tell you when,' he said.
