Safety net hospitals decry Medicaid spending cuts planned for Florida


Representatives of hospitals that invest heavily in physician training and care for the indigent held a news conference Monday to protest plans in the Legislature to slash Medicaid re-imbursement rates.

The cuts would undermine the state’s investments in training doctors, alliance members argued outside the Senate Office Building in Tallahassee.

Under the Graduate Medical Education Startup Bonus Program launched by Gov. Rick Scott two years ago, teaching hospitals draw $100,000 bonuses for every residency they add in key specialties. New residencies totaled 313 this year.

“We cannot train tomorrow’s physicians when every year our hospitals must re-evaluate their budgets,” said Lindy Kennedy, vice president for government relations for the Safety Net Hospital Alliance.

Steven Sonenreich, president and CEO of Mount Sinai Medical Center, cited a study showing that 80 percent of doctors remain in the state where they were trained.

“United States veterans wait 75 days on average to see a psychiatrist. There is a severe shortage in this state in many specialties, including the number of psychiatrists that we train,” Sonenreich said.

“Budget cuts to our institutions are felt when people are calling to make doctors appointments. It is that simple,” he said.

Training doctors without properly funding the hospitals where they would work “makes little fiscal sense,” said Leon Haley, dean of the UF College of Medicine-Jacksonville.

“To do so is to effectively spend taxpayers’ money to educate other states’ doctors,” Haley said.

The pressure on hospital budgets is coming from all sides — Scott’s proposed budget would cut $929 million from in Medicaid re-imbursements, paying 58 cents for every dollar the hospitals spend, alliance members said.

The House would cut $672 million, paying 62 cents on the dollar, and the Senate would cut $309 million, paying 68 cents.

Hospitals would be forced to pass some of their losses along to privately insured patients, alliance president Tony Carvalho said. The “hidden tax” would cost $2.7 billion under the governor’s plan, $2.4 billion under the House’s, and $2.13 billion under the Senate’s.

“These costs do not evaporate … because the hospital is reimbursed less than the cost of providing that care,” Carvalho said.

Approximately 4.5 million Floridians will participate in Medicaid next year, and 2.5 million uninsured, he said.

“That’s 6.5 million people — or almost one-third of the population — that when they get sick and come to a hospital, we can expect to get paid less than cost or nothing at all,” he said.

Additionally, the state would forego $414 million in federal matching funds under the House bill, Carvalho said. The Senate would give back nearly $200 million. All while state officials complain the feds shortchange Florida in health care money.

“It seems a contradiction in terms … to be forfeiting hundreds of millions in federal money for a very small savings in the General Revenue Fund,” Carvalho said.

Finally, the cuts would disproportionately harm safety net hospitals that care for most poor and indigent patients, he said.

The alliance comprises 14 public, teaching, and children’s hospitals that provide most of the bonus residencies and almost half the state’s Medicaid and indigent care.

Michael Moline

Michael Moline is a former assistant managing editor of The National Law Journal and managing editor of the San Francisco Daily Journal. Previously, he reported on politics and the courts in Tallahassee for United Press International. He is a graduate of Florida State University, where he served as editor of the Florida Flambeau. His family’s roots in Jackson County date back many generations.


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