Gov. Ron DeSantis’ vow this week to make deep cuts in the new state budget has health care advocates and lawmakers on edge, as the Legislature tucked nearly $100 million in so-called “special projects” into the health and human services portion of the more than $93 billion spending plan.
How many of the projects will survive DeSantis’ veto pen remains unclear. DeSantis, who has line-item veto power, formally received the spending plan Wednesday and will have to act before the state’s new fiscal year starts July 1.
“Good gravy, I don’t know what to say other than this is unprecedented,” Senate Health and Human Services Appropriations Chairman Aaron Bean, R-Fernandina Beach said. “It’s going to be big. It’s going to be painful. And it’s coming.”
DeSantis compared the looming budget cuts to the “Red Wedding” scene from the HBO series “Games of Thrones,” where a prominent family is murdered during a wedding feast. DeSantis said he will make vetoes --- as well as direct state agencies to curb spending --- to help balance a budget that was put together by lawmakers before the coronavirus pandemic crippled the state’s economy and slashed tax revenues.
The News Service of Florida obtained a nine-page spreadsheet that contains more than 175 health and human-services projects, slated to receive $99.4 million, that could get vetoed.
The most expensive project on the spreadsheet is $5 million for the Lake Erie College of Osteopathic Medicine, a private school that has the support of Senate President Bill Galvano, R-Bradenton. The special project slated to receive the least amount of funding is an adaptive tennis program called ACEing Autism. It would receive $25,000.
But Bean, who oversees health care spending in the Senate, said it isn’t just the amount of spending that will be taken into consideration when it comes to vetoes. He predicted that newer projects will be more likely to lose funding than established projects.
“I'm not criticizing any of them,” Bean said of new projects included in the budget. “But it’s just harder because you can say, ‘The state has gone years without it and what’s one more year?’ Also, a new project that is funded with recurring dollars will then be an ongoing liability for the state going forward, because once we fund that we will have to fund it again next year. That makes it harder. So, I think that will also be more scrutinized than others.”
The spreadsheet only contains projects that were funded with non-recurring --- essentially one-time --- general revenue or non-recurring trust fund money. But DeSantis isn’t constrained to vetoing only “special projects.”
Overall, lawmakers in March approved spending $39.36 billion in state and federal dollars on health and human-services programs in the coming year. As part of that, the Legislature boosted Medicaid payment rates for nursing homes by $78 million. The Florida Health Care Association, the state’s largest nursing home group, sent a letter to DeSantis in April asking him not to veto the increase.
Lawmakers also funneled $128 million in new state and federal funding to the Agency for Persons with Disabilities. The additional money is aimed at increasing enrollment in the Medicaid-funded iBudget program, which helps people with disabilities live in their homes and communities, and at providing pay increases for people who work with iBudget beneficiaries. Lawmakers also appropriated $241 million to wipe out two years of deficits the Agency for Persons with Disabilities accrued.
The Florida Developmental Disabilities Council sent a letter to DeSantis in May asking him to keep the increased funding intact.
Additionally, lawmakers approved spending $10.3 million in state money so the Agency for Health Care Administration can hire a contractor to help Florida get a Canadian prescription-drug importation program established.
Bean said he did not think the governor would veto funding for the Canadian drug-importation program or the Agency for Persons with Disabilities deficits. But he acknowledged that other increased funding for the Agency for Persons with Disabilities, which the Senate championed throughout the 2020 legislative session, could be “at risk.”
