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$1B for FL Medicaid in jeopardy

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By Jim Saunders 
6/17/2010 ©  Health News Florida

Extra Medicaid funding worth $1 billion to Florida is in jeopardy following a defeat in the U.S. Senate Wednesday on a procedural vote of 52 to 45, with all Republicans and 12 Democrats in opposition.  The vote was also a setback for an extension of some unemployment benefits and the so-called "doc fix," which would prevent sharp cuts in Medicare physician pay.

But the anger of physicians and the angst of many states led Democratic leaders to come out late Wednesday with a scaled-back version of the measure. They predicted it would pass, according to the Associated Press, but the anti-deficit mood in the Senate left the bill's status uncertain.  

Politico reports that the Senate could make a decision as soon as this week -- important to Florida, since the fiscal year begins July 1. 

Florida legislative and health-industry officials have been watching the Senate debate closely, after the U.S. House left the increased Medicaid funding out of its version of the bill. The extra Medicaid funding would go toward hospitals, nursing homes and cancer research. 

A federal economic-stimulus plan passed last year provided the higher matching rate through Dec. 31, 2010, but extending it through June 30, 2011, would give about $1 billion in additional money to Florida.

"If the delegation from Florida doesn't have the power to do it, maybe they (voters) ought to elect some new Congressmen,'' said state Sen. Durell Peaden, a Crestview Republican who is chairman of the Health and Human Services Appropriations Committee.

Tony Marshall, an official with the Florida Health Care Association who closely monitors Medicaid funding for nursing homes, said he is hearing "very mixed signals, because everybody wants to do it, but because of the cost, they're having a hard time in the Senate getting it done.''

Florida lawmakers did not bank on the increased matching money as part of their core budget for the 2010-11 fiscal year. But they included contingency language about how the money would be used if Florida receives its share.

Among the highest-profile issues in limbo: about $50 million in additional money for financially troubled Jackson Memorial Hospital in Miami. Also, lawmakers set aside about $20 million of the potential money for cancer research.

Paul Belcher, a senior vice president for the Florida Hospital Association, said the extension could mean an additional $344 million for hospitals and other health-care programs.

Lawmakers expected to use about $57 million to help offset Medicaid nursing-home rate cuts. Gov. Charlie Crist vetoed those rate cuts, so the federal money is not as critical to nursing homes as it might have been. But Marshall said receiving the federal money would allow savings in state tax dollars that would otherwise have to go to nursing homes.

They also planned to use part of the Medicaid money to help bolster the state's budget reserves. Peaden said receiving the additional federal money is particularly important because the oil leak in the Gulf of Mexico likely will reduce sales-tax and property-tax collections --- making Florida's budget problems worse in the future.

"We're going to have some bad times,'' Peaden said.

--Capital Bureau Chief Jim Saunders can be reached at 850-228-0963 or by e-mail at jim.saunders@healthnewsflorida.org.