The Low Income Pool (LIP) was implemented by the State of Florida in 2016 and provided $1 billion annually, which is matched with an additional $1 billion in federal funding, to ensure continued government support for the provision of health care services to Medicaid, underinsured and uninsured populations. The funds are given to MCH and other hospitals, clinics and providers for uncompensated care costs of medical services. Local governments, such as counties, hospital taxing districts and other state agencies (e.g. Florida Department of Health) provide funding for the non-federal share of the $1 billion LIP distributions.

During the 2014 Legislative Session, the Federal Centers for Medicare & Medicaid Services (CMS) authorized a three-year extension of the LIP program expenditures for uncompensated care costs. Federal CMS agreed to provide $608 million in funding toward Florida’s LIP program. Florida’s Safety Net Hospitals were adversely impacted by the cut in funding.

Moreover, the Standard Terms and Conditions agreed upon by the State of Florida and the federal government created a tiered system that no longer takes into consideration high Medicaid volumes and places significant emphasis on charity care. Despite having significant costs not covered by Medicaid or SCHIP, specialty licensed Children’s Hospitals do not meet the new federal criteria for charity care. Based on the new formula, the potential loss in funding to Nicklaus Children’s Hospital is $4.5 million.

Nearly two out of three kids treated at Miami Children’s Hospital are enrolled in Medicaid. MCH also treats a large percentage of medically complex children. These children require more specialized care and are more expensive to care for than children in other Florida hospitals.

These negotiations will direct impact health care priorities this upcoming Legislative Session. The State will spend the next few months implementing a new mechanism for distribution of uncompensated care funds. Please advocate with us to ensure that we receive adequate funding to continue providing services to our most vulnerable patients.

For further information on any of these issues, send an email to or call 305-666-6511 ext. 8435.