Budget conference: House includes $15 hourly pay, $37 million bump for cancer research
Give an inch: Bryan Ávila says the House has been generous to the nursing home industry.

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House and Senate budget writers are beginning to hammer out differences in health care spending plans.

Lawmakers formally kicked off budget negotiations on Tuesday, and House health care budget writers are offering to pay state employees and those who contract for the state at least $15 an hour. 

Budget writers also agreed to pare back a House move to eliminate $100 million in recurring general revenue from hospitals that was being redirected to nurse training. They also agreed to provide $37 million for cancer research, a priority for Gov. Ron DeSantis and First Lady Casey DeSantis, who is battling cancer. That amount is less than what the Governor initially called for, but it’s a win for the administration because neither the House nor the Senate budget initially included funding for increases in cancer research.

During the first budget conference between the House and Senate Rep. Bryan Ávila unveiled a proposed spending plan that includes nearly $14 billion in recurring general revenue, which is below the $14.2 billion that Legislative leaders agreed to set aside in overall allocations released late Monday night.

Ávila told reporters following the meeting the House did not include the $14.2 billion in its first offer because it wanted to be able to have room to adjust spending.

“In general, I think we are just trying to make sure that we have flexibility as we have negotiations with the Senate. So that flexibility is obviously important as we continue to have our conversations,” Ávila said.

Lawmakers meet annually for the 60-day regular Legislative Session and consider hundreds of different bills. But the only bill lawmakers must pass is the General Appropriations Act, which contains the funding for the state’s fiscal year.

The House’s first budget offer includes a $66 million recurring general revenue increase for nursing homes which, when combined with federal dollars, is an increase of about $165 million. That is below the Senate’s plan, which includes $303.9 million in additional funds for nursing homes.

The House also offered to include about $6.4 million in recurring dollars to Medicaid organ transplant providers whose rates had not been increased for more than a decade. But it’s not the only Medicaid rate increase the chamber agreed to fund. House budget writers also directed $1 million in recurring general revenue to increase the Medicaid rates paid to maternal fetal medicine providers, a move that matches what the Senate initially had planned to spend.

But not all Medicaid providers have been targeted for rate increases.

Florida Behavioral Health Association CEO Melanie Brown-Woofter said it’s been 20 years since community-based behavioral health providers have received an increase in their Medicaid base payments. This year, the association is asking lawmakers to spend $14 million in recurring general revenue to increase Medicaid rates. When matched with federal funds, it would amount to a $39 million increase.

Brown-Woofter told Florida Politics that community-based providers cannot tap into the newly created Medicaid supplemental payment program called direct provider payment. She remains hopeful that the Legislature will provide the funding necessary to increase rates. Brown-Woofter said the First Lady’s attention to mental health issues combined with the pandemic has shone the spotlight on the need for additional mental health funding.

“People are actually talking about it now. At dinner tables, people are talking about mental health which has not ever happened before,” she said.

House and Senate leaders overall agreed Monday to spend $42.4 billion in state revenue as part of the 2022-23 fiscal year budget, laying the groundwork for formal budget negotiations to begin. The agreement on top-line budget figures, known as allocations, only reveals the state’s general revenue spending. The total budget, including federal funding and state trust fund spending, will exceed $100 billion.

Lawmakers must reach a final budget deal by March 8 to satisfy the 72-hour “cooling period” required by the constitution before voting on the budget to end the 60-day Legislative Session on time.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.



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