TALLAHASSEE | A disagreement between the Florida House and Senate over health-care funding and Medicaid expansion could foreshadow a budget showdown that leaves hospitals and health clinics vulnerable.

The Senate is including in its budget a plan to use federal Medicaid expansion dollars to provide health coverage to roughly 1 million poor Floridians. The conservative House has blocked similar proposals for the past two years.

However, the House does hope to include about $2 billion in its budget to continue the Low-Income Pool, or LIP, a separate Medicaid program that is set to expire in June. State and federal officials are in discussion about how to keep LIP money flowing for another year or longer, but nothing has been agreed upon.

UF Health Jacksonville, a hospital perpetually on shaky financial ground, receives nearly $95 million from the program each year in addition to $26 million directly from the city budget that would also be in jeopardy if LIP goes away because of the lost incentive of a federal match. It and other safety net hospitals around the state are main beneficiaries of the program.

The Florida Senate has said the uncertainty around LIP makes it even more important to fight for Medicaid expansion and the roughly $50 billion in federal dollars that would come with it over the next decade.

These are Florida dollars; they dont come out of the ground in Washington, D.C., they come out of our pockets in the state of Florida, and we deserve to have them back here, Sen. Bill Galvano, R-Bradenton, said Tuesday when the Health Policy Committee unanimously approved the Medicaid expansion plan. And I assure you and I assure the Florida House that this will be the cornerstone of our 15-16 budget.

While the business and health-care industries are in support of the Senates health care proposal, conservative organizations like Americans for Prosperity and the James Madison Institute are opposed. These groups have singled out the simultaneous debate about LIP as reason why the federal government cant be trusted to keep its long-term promise to shoulder the majority of the costs of Medicaid expansion.

The U.S. Department of Health and Human Services has said that LIP cannot continue in its current form, causing some conservatives to interpret it is a veiled threat that the program would be allowed to expire and leave safety net hospitals that depend on the money in a lurch.

Our concern is anytime you take $50 billion from the federal government, youre asking for trouble, and we see that illustratively with the LIP funding, JMI President and chief executive Bob McClure said during the committee meeting.

Because of time constraints, the public comment period was abbreviated, and McClure wasnt able to read his entire prepared remarks. That statement gives even more insight to the connections he makes between the LIP extension and Medicaid expansion debates.

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House, Senate health-care funding disagreement shapes budget talks