The Senate unanimously passed its budget for the 2021-22 fiscal year yesterday, but not before lengthy discussion of one area that is seeing significant cuts — healthcare, primarily in cuts to hospital funding and the Healthy Start program.
The Senate budget totals $95 billion, leaving $5 billion in state reserves. The budget does not include the more than $10 billion in anticipated non-recurring federal pandemic relief funds, which are currently under review and will be addressed as the Senate works with the Florida House of Representatives to pass a final budget for the upcoming fiscal year.
Under the Senate budget, hospitals take the largest hit with a proposed $251.2 million reduction to inpatient and outpatient base Medicaid rates, impacting all hospitals.
Additionally, $77.3 million was eliminated from hospitals that treat large numbers of Medicaid patients.
Hospitals are not happy. The Florida Hospital Association President and CEO Mary Mayhew said previously, “As Florida recovers from the COVID-19 pandemic, now is not the time to cut critical state funding to a vital safety net program and to the hundreds of thousands of doctors, nurses, and hospital staff who provide care to Medicaid patients. Our health care heroes risked their lives, and that of their families, to protect and care for us – they need our support now more than ever.”
Senate Health and Human Services Appropriations Chairman Aaron Bean (R-Fernandina Beach) described the budget as a “Budget full of tough decisions.”
He said that while working through the budget, he has a “buy back list” and that extra money for hospitals is on that list. He’s “hoping to have another shot at making those tough decisions.”
In developing the budget, the committee considered money hospitals received through the federal CARES Act. Also, Bean said his committee’s budget proposed new opportunities for hospitals to take advantage of what is known as “supplemental” Medicaid funding to offset the reductions.
The Senate spending plan recommended the state stop providing optional Medicaid benefits including services for 19- and 20-year-old residents (with the exception of pregnant women, people in foster care and people with developmental disabilities), adult vision, hearing, chiropractic and podiatric services, as well as an over-the-counter drug benefit. In all, eliminating the optional beneficiaries and services would save $111 million.
Healthy Start, a statewide program that provides risk screenings for pregnant women and babies, saw its budget reduced by roughly two-thirds in this budget.
Bean explained to concerned senators that during the budget process they were looking for duplication of services and found it with Healthy Start. He said he was encouraging Managed Care to subcontract with Healthy Start. “Hopefully we can bring the parties together.”
But there were bright spots within the budget.
In a released statement following the vote Senator Kelli Stargel (R-Lakeland), Chair of the Senate Appropriations Committee, said, “We appropriate(d) resources to fully fund the Medicaid program, which as a result of the pandemic has over 730,000 additional enrollees for a caseload of 4.5 million Floridians. This comes at an increased cost to the state of more than $1 billion. We also fully fund the KidCare program serving 229,000 children with high quality health insurance. In education, we maintain an unprecedented level of per student funding for K-12 education, including a $500 million allocation to raise teacher salaries. We also fully fund the Bright Futures Scholarship Program, and other important need and merit-based student financial aid.”
Senate President Wilton Simpson (R-Trilby) said, “Our budget includes a $50 million increase in our investment in Florida’s Child Welfare System. We also take the first big step towards increasing the minimum wage for our state workers, bringing wages up to $13 per hour more than three years in advance of the timeline outlined in the constitutional amendment that passed last fall, which will benefit more than 10,000 state workers. Among other priorities, our budget modernizes our documentary stamp distributions to dedicate a steady stream of funding in three key areas of infrastructure – affordable housing, wastewater, and mitigating sea-level rise. We also provide funding for the South Florida Water Management, in partnership with the U.S. Army Corps of Engineers, to expedite implementation of the Lake Okeechobee Watershed Restoration Project. These are key infrastructure investments that require a comprehensive, long-term approach, and I am pleased to see this budget establish this important framework.”
At the August General Revenue Estimating Conference, the first following the onset of the COVID-19 Pandemic, estimates were for a $5.4 billion revenue loss over the 2020-21 and 2021-22 fiscal years. An estimate in December 2020 restored $2.1 billion, leaving a $3.3 billion loss compared to pre-pandemic estimates. For Fiscal Year 2021-22, the estimate of recurring general revenue is $1.4 billion below pre-pandemic estimates.
Tuesday, anticipated revenues were revised upward by $1.475 billion in FY 2020-21 and by $550.8 million in FY 2021-22, for a two-year combined increase of $2.026 billion. The statement from the Senate said, “the revised estimate will help inform decision making moving forward as the final budget, implementing, and conforming bills are developed in partnership with the Florida House of Representatives.”