Show me the money: Senate and House ready to negotiate health care spending

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Health care spending promises to be one of the more divisive issues as lawmakers begin to finalize the details of the only must-pass bill of the 2022 Session: the General Appropriations Act.

Hospital funding, nursing training and providing women access to long-acting reversible contraception are among the issues that House and Senate health care conferees will negotiate in the next three weeks as legislators try to bring the Session to a close.

The Senate has proposed in its recommended budget spending $47.8 billion on health care and social service programs, including $13.9 billion in state funds. The House has recommended in its proposed budget spending $47 billion, including $13.9 billion in state funds.

The House and Senate have passed spending plans that eliminate state funding to enhance the Medicaid rates 26 hospitals receive. Those hospitals qualify for the “critical care funds” because of the amount of Medicaid care they provide.

The Florida Hospital Association and the Safety Net Hospital Alliance of Florida have lobbied to keep the funding intact. Gov Ron DeSantis also included funding for the critical care funding in the proposed budget he unveiled for the 2022-23 fiscal year.

But the House’s decision to take $100 million from Florida hospitals to help beef up the numbers of nurses in the state is not a done deal, Senate President Wilton Simpson told reporters on Thursday.

“Clearly it’s going to be in conference and it’s going to be discussed,” Simpson said when asked if he supported the proposal.

Simpson also told reporters he was going to use his influence to provide low-income women access to long-acting reversible contraceptives, or LARC.

As budget negotiations were finalized last year, Simpson said, he “sprinkled” $2 million to provide girls and low-income women access to contraception. Sprinkle is legislative parlance for including money as the budget is finalized for projects or programs that often never are publicly discussed.

Long-acting hormonal contraception is 20 times better at reducing unwanted pregnancies than birth-control pills or patches, because LARCs require no attention after they are inserted. According to the Mayo Clinic, intrauterine devices, contraceptive implants and contraceptive injections are all considered LARCs.

But LARCs must be inserted by health care professionals and can be expensive, putting them out of reach for low-income women. Simpson said he wanted to use the money in the budget to make LARCs more affordable for young women.

“It is life changing,” said Simpson who predicted that making them available for low-income women would prevent “tens of thousands of abortions.”

“I see that as a pro-life issue,” Simpson added.

Sen. Aaron Bean, a Fernandina Beach Republican, and a member of Simpsons’ leadership team, said the issue was a “lightning rod” and that he was met with opposition from Gov. DeSantis’s office and the House.

The Senate prevailed in getting the money into the budget last year but DeSantis ultimately vetoed it.

Simpson said Thursday he stands behind his commitment to providing women access to birth control.

“This is the 11th hour. I am putting it in,” Simpson said.

While the House budget is smaller than the Senate’s proposed spending plan, the chamber directs more funding to the Department of Children and Families than the Senate. The House’s proposed budget directs $3.9 billion to the department while the Senate recommends spending $3.7 billion.

The House also outspends the Senate when it comes to funding the Department of Veteran Affairs and the Department of Elder Affairs. The House directs $325 million to the Department Elder Affairs, as compared to $323 million from the Senate.

The House budget also directs $201.3 million to Veterans Affairs, whereas the Senate budget spends $166.9 million.