By John Kennedy
The News Service of Florida
With Congress looking likely to steer another $1 billion in Medicaid money to Florida, a fight now is brewing over how to spend the cash in a state budget potholed with program shortfalls.
Senate Health and Human Services budget chief Durell Peaden, R-Crestview, was joined by two Democrats on his committee in a letter they planned to send Thursday to Senate President Jeff Atwater, R-North Palm Beach, insisting that the cash go to offsetting deep cuts in health and social programs.
“If the money is dedicated from Washington to come down here and help solve our problems, it shouldn’t be taken and put into the purview of another appropriations committee,” Peaden said.
Peaden and Sens. Nan Rich, D-Weston and Eleanor Sobel, D-Hollywood, signed the letter they hope will push Atwater toward pouring the full $1 billion that could be headed to Florida with congressional approval of an extension of enhanced federal matching money for Medicaid, dubbed FMAP.
The provision was included in legislation approved Wednesday by the U.S. Senate which extends unemployment and health insurance, but must be reconciled with a similar measure approved in December by the U.S. House.
If finally resolved by Congress, Florida could be in line for slightly more than $1 billion, which Peaden and advocates for state health programs want to use to close an already $328 million shortfall in revenue needed to continue current programs, even in a sharply scaled-back form. The Senate HHS panel, for example, is planning to finance the costly Medically Needy and Meds A/D prescription drug program for elderly and disabled Floridians with $252 million – but only for six months in 2010-11.
Since federal health care stimulus money expires in December, many health and social service programs may be kept alive for a full year only with the FMAP windfall. But budget-writers in both the House and Senate are looking at the cash from Washington as playing a pivotal role in easing the overall budget shortfall of as much as $3.2 billion.
“That billion dollars from FMAP would be great,” said Sen. J.D. Alexander, chairman of the Ways and Means Committee. “It would go a long way toward helping us meet needs across the budget.”
“Across the budget,” is the pivotal phrase.
While the federal dollars would have to be spent helping maintain health and human service programs, the injection of cash could allow lawmakers to withdraw some general revenue dollars and steer it elsewhere. Last spring, about $700 million in federal health care aid was diverted from state programs serving the poor, elderly and disabled and used to patch gaps in other state services.
With the FMAP money looking unlikely as recently as last week, Atwater and other Senate leaders have said little about how it could be spent. Atwater on Wednesday unveiled budget allocations that outstripped the House level of funding for schools, but with $6.4 billion for health and human services, fell about $400 million below the House stance.
Combined, education and health and human services absorb about 75 percent of state general revenue. And it’s likely that any tug-of-war between the House and Senate over distributing FMAP money will pivot on those two areas of spending.
The House hasn’t said much about how it would spend FMAP money. But health care advocates say the House has indicated it would like to keep as much as half of that $1 billion in reserves, to fend off what is expected to be a $5 billion budget shortfall next year. House Speaker Larry Cretul, R-Ocala, has said he wants a total budget reserve of $1 billion in the 2010-2011 spending plan.
With Atwater a statewide candidate for chief financial officer, it’s likely that the Senate may look at education more favorably when it comes to spending any kind of late-hour dollars flowing from the federal government, some senators acknowledged.
“People pay attention to schools, and parents vote,” said Sen. Steve Wise, R-Jacksonville, chairman of the Senate’s K-12 budget committee. “If you’re running statewide, you want to do right by schools.”
