Depressed disabled senior man sitting on wheelchair

After caring for the sick and holding the hand of the dying during the pandemic, doctors and nurses who treat the indigent and the elderly are being rewarded by state legislators with budget cuts that – if passed – will significantly impact their facilities.

A proposal unveiled by House Health Care Appropriations Chairman Bryan Avila, R-Miami Springs, recommends reducing Medicaid payments for inpatient and outpatient hospital care by $288 million.

Moreover, the House plan wants to eliminate $226 million from what the Safety Net Hospital Alliance of Florida calls the “critical care fund.” The fund is used to offer enhanced Medicaid payments to 28 hospitals that provide the largest amounts of charity care in the state, according to the industry group.

Nursing homes also are on the chopping block, with a 2% cut to Medicaid reimbursements, or $80.4 million in state and federal funding.

Florida Health Care Association President Emmett Reed said the proposed Medicaid cuts to nursing homes would translate to about a $125,000 reduction in payments per facility per year.

“With Florida’s growing older population, it’s critical that our nursing centers have the resources they need to recover from the pandemic, strengthen their workforce, upgrade their aging physical structures and continue implementing solutions to ensure seniors have access to high-quality long-term care,” Reed, whose association is the state’s largest nursing home industry group, said in a statement.

Mary Mayhew, Florida Hospital Association president and CEO, in a statement called the House’s proposed reductions to hospitals “a gut punch to the doctors, nurses and health care heroes who risked their lives responding to this (COVID-19) crisis. It is simply beyond belief that during a public health emergency, some state lawmakers chose to balance the budget by cutting funding that serves the elderly, disabled and most vulnerable families in our state.”

The individual responsible for these suggested cuts is Florida House Speaker Chris Sprowls, R-Palm Harbor, who is trying to find money to allow postpartum women to continue receiving Medicaid benefits for a full year following delivery.

“No matter where you go in this state, no matter what organization you are or what school or what community center, when you ask people who are our most vulnerable population, the common themes that everyone – without exception – will mention are new moms and their babies,” he said.

AARP Florida Associate State Director Zayne Smith had not analyzed both chambers’ budgets by The Miami Times deadline. But she told News Service of Florida that nothing good comes from pitting one group against another.

“All groups (of Medicaid recipients) are vulnerable, quite honestly,” she said. “I don’t think you can pit one group against another. It’s a lose-lose scenario.”

Sen. Aaron Bean, R-Fernandina Beach, Senate Health and Human Services Appropriations Chairman, also called for steep reductions to hospitals, though they would be less than what the House is seeking.

The Senate proposal would reduce hospital inpatient and outpatient Medicaid rates by $251.2 million. Also, the Senate would reduce the “critical care fund” by $77.3 million, compared to the House’s proposed $226 million reduction.

Unlike the House, the Senate proposal wouldn’t cut funding for nursing homes.

Among the similarities in the budgets, the House and Senate propose eliminating over-the-counter drug benefits for adults on Medicaid, which would lead to a $22.6 million reduction.

Both chambers also agree the state should increase Medicaid reimbursement rates for institutions that care for people with intellectual and developmental disabilities, but they don’t agree on the amount. The House has proposed increasing the rates by $12.1 million in overall funds, while the Senate has proposed a $36.6 million increase.

Jointly funded by the state and federal governments, Medicaid is a safety net program that provides health coverage to poor, elderly and disabled residents. Enrollment in Florida’s Medicaid program stands at more than 4.5 million people, an increase of more than 730,000 people in the past year since the COVID-19 pandemic hit the state.

The proposals are an early step that will ultimately be part of House and Senate leaders negotiating a final budget for the fiscal year that starts July 1.