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Chance of seeing Medicaid $ dims

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By Jim Saunders
6/25/2010 © Health News Florida

Florida's chances of receiving up to $1 billion in additional Medicaid money appeared to be in deep trouble Thursday after U.S. Senate Republicans again blocked a bill that includes help for cash-strapped states and unemployed people.

In a 57-41 procedural vote, Democrats fell three votes short of the 60 needed to move forward with the bill. The New York Times reported that Senate Majority Leader Harry Reid, D-Nev., said he would move on to other issues next week because he saw little chance of winning Republican votes.
 
The National Conference of State Legislatures, which has pushed for the additional Medicaid money, posted a short notice on its website Thursday night saying it is "not clear when or if there will be further action" on the bill.

Congress initially proposed sending $24 billion to states through increased federal Medicaid matching rates, with about $1 billion going to Florida. Reid scaled back the overall amount to $16 billion this week in a futile attempt to win votes; it was not immediately clear how much Florida would collect under that scenario. 

If Florida does not receive the additional money, it does not mean state lawmakers will have to slash the budget for the fiscal year that starts July 1. But it will mean that the state will not receive additional money to help pay for programs.

Earlier this year, Gov. Charlie Crist was so confident that Florida would get the increased Medicaid money that he used it in his proposed budget.

Lawmakers did not go so far when they passed a final budget April 30, but they included a list of about $230 million in spending items --- such as money for hospitals, nursing homes and cancer research --- that was contingent on receiving the Medicaid money. Also, they hoped to use hundreds of millions of dollars to bolster the state's reserves.

State House leaders were concerned throughout this spring's legislative session that Congress would not approve the additional Medicaid money, and Health Appropriations Chairwoman Denise Grimsley, R-Lake Placid, said in an e-mail that Thursday's developments were "consistent'' with the way lawmakers handled the issue. She said it also reflects the need to overhaul the state's Medicaid system to help hold down costs and prevent service cuts in the future.

One of the biggest losers if Florida doesn't get the money will be Miami's financially troubled Jackson Memorial Hospital, which was expected to receive $50 million.

Ron Book, who lobbies for the hospital in Tallahassee, said last week the $50 million would help "plug some of the holes'' in Jackson's finances. The additional Medicaid money would come through the extension of an increase in what is known as the Federal Medical Assistance Percentages, or FMAP.

"If FMAP doesn't get approved, the blow that it will deal to Jackson is significant and substantial,'' Book said.

Crist continues to hold onto the possibility that Florida --- and Jackson --- will receive the money.

"While we are disappointed that Congress failed to act, we remain hopeful that an FMAP extension will be approved before the end of the year,'' Crist spokesman Sterling Ivey said in an e-mail this morning 

Thursday's vote was the second time in little more than a week that Senate Republicans joined together in procedural votes to block the Medicaid money and an extension of jobless benefits. One Democrat, Ben Nelson of Nebraska, voted with Republicans, who primarily argue that the bill should not add to the federal deficit.

In the Senate, 60 votes are crucial because that is the threshold needed to overcome a filibuster.

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