FPI Budget Analysis Highlights Victories and Setbacks for Florida Health Care – The State of Reform

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Unfinished budget negotiations in the legislature push the session past its scheduled adjournment on Friday, due to a mandatory 72-hour “cooling off” period before policymakers can vote on proposed appropriations bills.

Last week, the Florida Policy Institute (FPI) released a 56-page report To analyse on the House and the Senate proposed budgets for the financial year 2022-23as well as their comparison with Budget proposed by Governor Ron DeSantis, which was announced in December 2021. The Senate’s proposed budget ($108.6 billion) represents a 7% increase over the current fiscal year budget of $101.5 billion. The House’s proposed budget ($105.3 billion) is a 3.7% increase, while DeSantis’ proposal ($99.7 billion) is a 2% decrease.

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The FPI’s analysis found that the state’s operating budget increased significantly – by around 17.6% – in the 2020-21 and 2021-22 fiscal years. This is primarily due to an influx of federal funding in response to the pandemic. State agencies expected to benefit from these funds include the Agency for Health Care Administration (AHCA), the Department of Health, and the Department of Economic Opportunity.

Much of the analysis focused on proposed health expenditures. The proposals from both chambers exceed current year funding in the health and human services budget ($44.5 billion). The House and Senate are proposing $47.1 billion and $47.8 billion, respectively, though the report says federal funding accounts for more than 70% of both chambers’ proposals.

Most of this funding goes to the Agency for Health Care Administration to support Medicaid services. The FPI confirmed that neither the House nor the Senate had proposed reductions in eligibility for Medicaid services, but criticized the two chambers’ proposed reduction in reimbursement of $300 million for services provided by hospitals. of the safety net. The Chamber is also proposing a reimbursement cut of $215.9 million for all hospitals. The House aims to redirect public funds ($100 million) from this reduction towards the training of future nurses. The two chambers’ proposals would instead rely on additional payment programs to support safety net programs.

“The proposed hospital rate reductions underscore the ongoing challenges of unpredictable year-to-year funding to maintain sufficient hospital capacity to meet the needs of Medicaid beneficiaries as well as other underserved communities,” the analysis said. . “If Florida lawmakers choose to expand the state’s Medicaid program, millions more in stable federal funding would support hospitals.”

Wage and salary increases for workers at various health care facilities, such as hospitals, nursing homes and Medicaid managed care prepaid salary plans, are included in both room proposals. The House is proposing to raise the minimum wage to $13 an hour, while the Senate is proposing an increase to $15 an hour.

Another area of ​​concern for the REIT is funding for Home and Community Services (HCBS). The Senate is proposing $6 million to remove about 500 people from the waiting list for the Alzheimer’s Disease Initiative (ADI), which provides respite and support services for people with Alzheimer’s disease and family caregivers . The Senate is also proposing $4.9 million to remove 539 individuals from the Community Care for the Elderly (CCE) program, which provides case management and other continuing care services to at-risk and presenting seniors. a functional impairment.

The House proposal includes more funding than the Senate to remove more people from the ADI and CCE waiting lists. The House also includes an additional $41.9 million to remove approximately 798 people from the waiver waiting list for the Agency for Persons with Disabilities (APD), which provides medical, behavioral and residential services to people with severe developmental disorders.

However, these funds cover only a fraction of HCBS’s demand. The REIT reports that there are currently 8,550 people on the ADI waitlist, 57,022 people on the CCE waitlist and 22,759 people on the APD waitlist.

HCBS is expected to receive additional support of an increased federal matching percentage of 10% from the American Rescue Plan Act (ARPA) for one year. According to the analysis, Florida has received conditional federal approval for a $1 billion spending plan he submitted in 2021.

Both chambers allocate funds for health care services to inmates. The Senate and House are proposing approximately $568 million and $569 million, respectively. Both are slightly above current year funding of $567 million.

However, the FPI criticizes the general lack of progress by the State in terms of financing public aid. Per capita government spending in Florida has consistently lagged neighboring states and the nation as a whole over the past decade, according to the report. According to Census data from 2004 to 2019, Florida also consistently ranked at or near the bottom in spending on public welfare (49th), elementary and secondary education (49th), and higher education (50th).

“Florida’s low ranking is problematic because general revenue helps fund education, health and human services, corrections, natural resource management, growth management, transportation projects and operations. general government,” the analysis says.