More than $800 billion in cuts to Medicaid are wrapped into the health care reform bill that Senators are now considering.
The proposal would restructure the way Medicaid is financed, moving it from guaranteed funding based on need to a per-person cap with funding based on 2016 levels.
The resulting cuts would leave Florida with few options to make up for the loss in funding, says Joan Alker, director of the Center for Children and Families at Georgetown University.
"Florida's going to be faced with very bad choices. Either you raise taxes or you cut Medicaid or you cut other parts of your budget like education and none of those is a good choice," Alker said during a health care summit in St. Petersburg on Friday.
She says the change would mean significantly less money for seniors in nursing homes, the disabled and more than 40 percent of Florida's children who are covered by Medicaid.
The uninsured rate for children has dropped from 11 percent in 2013 to under 7 percent in 2015.
Florida is especially at risk under a Medicaid cap, Alker said. That’s because Florida does not spend a lot of money per person on Medicaid compared to other states. So when the funding is capped based on 2016 levels, Florida will get less money per person.
A per-person cap is not as responsive to growth in health care costs, she said. That could put the state at risk if there is a new epidemic, such as Zika, that requires additional spending, Alker said.
“I think Floridians really should be asking a lot of questions about how would these Medicaid cuts affect Florida,” Alker said.
When children lose access to Medicaid, there are serious consequences, Alker said.
“When kids have access to Medicaid they are healthier, they do better in school, they have higher high school graduation rates and they have better economic outcomes,” she said.
The Medicaid program has been in place more than 50 years.
“This has nothing to do with repealing the Affordable Care Act, which is what Congress says they are doing,” Alker said. “It’s really shocking to me that Congress would consider making these radical changes with no hearings, no public discussion about this, no scrutiny of how is this going to affect my state.”