Peter Schorsch
With the end of the Legislative Session mercifully (hopefully?) in sight, the discrepancies between Senate and House budgets on various issues are becoming more heightened.
At times like these, the two sides need to learn how to swallow their pride when it’s clear one chamber has the better plan.
This lesson would serve them — and the people of Florida, the ones they are supposed to be serving — when the subject turns to funding of our state’s hospitals. The Senate and House have agreed on a whopping $651 million in cuts for hospitals, but they differ significantly on how those cuts should occur.
It really seems this is an issue where the House needs to step aside and make room for the Senate’s entirely more reasonable approach.
The Senate has proposed a comprehensive budget model that applies cuts to supplemental fees across the board, phasing the $651 million in cuts evenly. The House plan, on the other hand, complicates the budget cuts with a four-tier system that favors safety net hospitals.
With the House plan, hospitals in the first two tiers would receive the least cuts, based on their higher percentages of Medicaid and charity care. While this may initially seem like a reasonable idea, it actually creates redundancy in the funding process — and that means a waste of taxpayer money.
The House’s tier structure for Medicaid and charity care made a lot more sense before Gov. Rick Scott and AHCA received a commitment from the federal government for $1.5 billion in Low Income Pool (LIP) funding. The whole point of LIP funding is to reimburse hospitals for Medicaid and charity care.
It makes no sense to do the same thing through the House plan.
These same hospitals being spared the full impact of the cuts because of their Medicaid and charity services will receive reimbursement for those same services through the Low Income Pool (LIP). This means these hospitals, but only these hospitals, would receive both an exemption from cuts AND additional funding for the same reason.
Just as these hospitals are doubling up on benefits, hospitals in the lower two tiers would be doubled up on punishments in the House plan. These hospitals wouldn’t receive the same amount of reimbursement for patient care from LIP and would also experience the most burdensome cuts, leaving them and the patients they care for to make up the costs. This threatens the care of patients, as the hospital they depend on for treatment suffer a disproportionate level of cuts to funding.
The Senate plan, while still painful, at least spreads the pain around equally. If hospitals are going to be cut no matter what, it’s better for them to share the burden and buffer the effects of the cuts, rather than having it all dumped on only select hospitals and their patients.
The Senate’s plan takes into account the well-being of the patient and as well as the efficiency of the cuts, two factors that are missing in the House proposal.
As the session careens toward a conclusion, it’s inevitable that there will be plenty of issues where the House has the better plan. When that happens, the Senate should recognize it and act accordingly. But on the issue of hospital funding cuts, the Senate budget is clearly the way to go.
It’s time the House agreed.
