Lawmakers hit reserves to salvage 2 health programs for the critically ill and elderly from budget cuts

Apr 24, 2008

A $300 million infusion salvages 2 programs for the critically ill and the elderly.

John Kennedy
Tallahassee Bureau Chief
Orlando Sentinel–April 24, 2008


Bowing to pressure, House and Senate budget negotiators used $300 million from reserves Wednesday to erase sharp cuts planned for a pair of health programs serving 40,000 critically ill and elderly Floridians.

The cash infusion keeps alive for another year the state’s Medically Needy program and Medicaid Aged and Disabled coverage, which had been included in about $1 billion in proposed cuts to health and human services programs.

Even after adding the extra cash, lawmakers are carving deeply into health and social programs and education to offset an expected $3 billion drop in tax collections caused by the slumping economy.

But those kept in limbo for months by budget-cutting lawmakers said they were breathing easier.

"I’m a little overcome with emotion right now," said Mary Ellen Ross, 55, a Delray Beach bone-marrow transplant recipient who has relied on the Medically Needy coverage for hospital treatment since 1999.

Ross, who heads the Florida Transplant Survivors’ Coalition, was in town to lobby lawmakers. Earlier, a campaign organized by the Florida Hospital Association delivered 17,000 petitions to Gov. Charlie Crist and legislators, urging that they retain the program.

Hospitals, which face between $148 million and $238 million in payment cuts in the proposed $65 billion-plus budget being crafted, warned that without the programs, even more poor, elderly and frail Floridians would wind up in their emergency rooms.

Despite the $300 million infusion, "these hospital cuts are severe, and they’re going to be transferred to the community," said Tony Carvalho, lobbyist for the Safety Net Hospital Alliance, which includes Orlando Regional Healthcare.

Still, using money from the Lawton Chiles Endowment Fund marked a milestone in this year’s budget talks between the House and Senate. Crist has urged lawmakers to tap as much as $400 million from the endowment, a $2.2 billion health-care reserve financed by the state’s 1997 settlement with cigarette makers.

A day earlier, the state’s largest teachers union pushed for lawmakers to use the state’s $1.4 billion "rainy-day fund" to erase roughly $300 million in planned cuts to public school spending, following $500 million in cuts this year.

House and Senate leaders largely dismissed the teachers’ pleading. But they were clearly more concerned about the potential political risk of slashing a pair of high-profile health programs in an election year.

"With these dollars, we help our poorest of the poor," said Senate budget chairwoman Lisa Carlton, R-Osprey.

The Medically Needy program covers transplant and catastrophic-illness costs for 20,000 Floridians whose incomes make them ineligible for Medicaid, but whose illnesses make it difficult for them to obtain insurance.

The House had tried to eliminate the program’s hospital payments, while the Senate sought to limit it to children and pregnant women, eliminating 16,000 patients statewide.

The so-called Meds AD program provides health coverage for 24,000 seniors and disabled Floridians living well below the poverty line. It would have been wiped out completely by the Senate, saving $355 million, including federal dollars.

The extra $300 million allows both programs to continue unaffected when next year’s budget takes effect July 1.

Also Wednesday, House and Senate negotiators ironed out dozens of differences between their chambers’ spending plans and turned over the remaining sticking points to budget chiefs for more work.

Among the unresolved differences are $100 million in Everglades restoration money, sought by the Senate but cut by the House; and public school cost-of-living dollars sought by Miami-Dade lawmakers, including House Speaker Marco Rubio, R-West Miami.

Rubio and Senate President Ken Pruitt, R-Port St. Lucie, are expected to take over the final horse-trading by the weekend as lawmakers push toward a scheduled May 2 finish.