Questions swirl around extra health care money

health care spending
The state is set to get $400M, but plans to spend it aren't in place.

Florida is getting another boost in federal money after the Biden administration extended a public-health emergency, but it’s unclear if the Republican-controlled Legislature will use the extra cash to bolster health care spending.

The state learned this week that it will receive about $400 million in additional federal Medicaid funds in the upcoming fiscal year, but lawmakers so far haven’t included it in a proposed budget they are trying to finalize as the 2021 Legislative Session draws to an end.

Some lawmakers say the money needs to be used, as they worry the budget under consideration wouldn’t properly fund the Medicaid program, which provides health care to 4.7 million poor, elderly, and disabled people in the state.

House Speaker Chris Sprowls “is taking a look” at the  extension of the public health emergency and the additional funding it brings, according to  spokeswoman Jenna Sarkissian.

But Senate Health and Human Services Appropriations Chairman Aaron Bean told The News Service of Florida that, “I don’t now know that we are including it.” He added that the money is a one-time infusion and is not a recurring source of funding for Medicaid.

The Biden administration issued a 90-day extension of the COVID-19 public-health emergency. Medicaid is jointly funded by the state and federal governments, and Florida will receive roughly $400 million in additional money because of a continued boost in the federal share of money.

Congress agreed last year to increase the federal matching rate by 6.2 percentage points to help states pay for Medicaid as enrollment in the program soared during the pandemic.

Though the Biden administration said it planned to keep the public health emergency — and the additional funding — intact through the end of 2021, legislative leaders haven’t included the money in budget proposals.

For now, Bean said the plan is for the state Agency for Health Care Administration, which administers the state’s Medicaid program, to submit a budget amendment in the summer and put the additional funding in reserves.

But some lawmakers question why the money would go into reserves and not be used to help reduce Medicaid waiting lists for long-term care programs and programs that serve people with intellectual and developmental disabilities.

‘It certainly would go a long way for children and families who are struggling. It would go a long way for seniors who are on wait lists,” Rep. Allison Tant. “It would go a long way to help human beings, which is what I think we’re supposed to do here.”

Sen. Audrey Gibson agreed, noting that the proposed House and Senate health-care budgets would make permanent a controversial move to eliminate a 90-day retroactive period the federal government allows for people to sign up for Medicaid. To save $100 million, Florida has required people to sign up for Medicaid the same month they become eligible. If they don’t, they are responsible for any health-care bills they accrue.

The policy has been temporary, but the House and Senate have proposed making it permanent.

“The fact that we have nearly 1 million people uninsured, the fact that people are accumulating Medicaid bills until they apply for Medicaid, why would we leave $400 million on the table?” Gibson said. “It’s an embarrassment if we do.”

Early versions of the House and Senate budgets also proposed slashing Medicaid payment rates for hospitals. But those proposed budgets were based on December 2020 forecasts. Economists updated estimates this month, showing lawmakers would have an additional $2 billion in general revenue than previously anticipated.

Senate negotiators on Saturday made a budget offer to the House that, in part, would reduce a proposed hospital rate reduction from about 8% to 1%. But the health- and human-services budget — along with most of the rest of the budget — remains unresolved as it continues to be negotiated by legislative leaders.

Justin Senior, CEO of the Safety Net Hospital Alliance of Florida, said the additional funds should help assure lawmakers that the Medicaid budget won’t run at a deficit in the coming year.

“Our overall hope here is this actually takes pressure off and gives them the flexibility and freedom to fully fund the hospitals at the same rates they were last year,” said Senior, whose group represents public, teaching and children’s hospitals.


Republished with permission from The News Service of Florida.

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