By John Kennedy
The News Service of Florida
A quarter-million more low-income Floridians would be moved into managed care health programs, property-owners in 25 counties could face tax hikes, and the state’s popular Bright Futures scholarship program would prove tougher to get, under plans approved Friday by Senate panels trying to close a budget gap of as much as $3.2 billion.
With Medicaid spending accounting for about half of the state shortfall, the Health and Human Services budget committee advanced a plan to move 247,671 Medicaid recipients across 19 counties into HMOs, a shift expected to save the state $28.6 million next year – but close to $100 million annually in future years.
Still, with 2.7 million Floridians crowded onto Medicaid rolls now absorbing about one-quarter of all state spending, HHS budget chairman Sen. Durell Peaden, R-Crestview, conceded that gains from the dramatic effort were less than hoped for once they were reviewed by state analysts.
“It is not as much as anticipated,” Peaden said, noting that several managed care organizations testifying before the committee had suggested they could provide robust savings for the state.
“You make the jump and say we’re going to make great savings, but you say, `wait a minute.’ You’ve got to talk to the folks that count the beans in the back and the folks that do the statutory language and the folks that have made policy for the last 15-20 years and if it doesn’t jibe, those proposed savings are absolutely false.”
The 19 counties targeted for the HMO move are those that have two or more managed care Medicaid plans already operating and are considered to have the capacity to serve a larger population. Among them are most Central Florida counties, including Orange, Seminole and Osceola, along with Miami-Dade, Hillsborough, Palm Beach and Pinellas counties. Already, about 1 million Florida Medicaid patients are treated through managed care.
Anne Swerlick of Florida Legal Services cautioned lawmakers about moving too swiftly with the HMO expansion, saying it could threaten health care and prove disruptive for the care of developmentally disabled Floridians, foster children and severely ill patients.
“We think it’s premature to roll these populations into a Medicaid HMO expansion until we can evaluate their needs,” Swerlick said.
Other Senate budget panels Friday completing their work included the Pre-K-12 committee, which approved spending that includes a $15.41 per-student increase on top of the current, $6,866 level. But the Senate achieves the boost by including dollars anticipated from a .25-mill property tax that now could be levied by an extraordinary vote of local school boards, instead of the current-required voter approval.
Only 42 of the state’s 67 counties enacted the levy last year. But Senate spending is reliant on all Florida counties imposing the tax.
Although Senate President Jeff Atwater, R-North Palm Beach, has vowed that chamber will not increase taxes or fees this year, Pre-K-12 budget chairman Steve Wise, R-Jacksonville, said the property-tax strategy met the criteria because it would be levied by other officials.
“That’s somebody else taxing,” Wise said.
In education, the Senate and House have taken different approaches – with the House cutting per-pupil spending by $30-a-student, and reducing funding for higher education while the Senate managed a $128 million increase.
The Senate boosts funding for the state’s Bright Futures’ scholarship program by $31.4 million over the current year’s $418.9 million level. But the Senate is on track to phase-in a system where the popular scholarships that provide either 75 percent or 100 percent of base tuition become tougher to get.
Almost 180,000 Florida students are expected to be eligible for the scholarships next year, according to legislative analysts, bringing the program’s price to $450 million, compared with $75 million when the scholarships were launched in 1997.
Legislators began reining-in the costs last year with program changes that look certain to continue in 2010-11. The Senate Higher Education budget committee Friday approved legislation (CS/SB 1344) that phases-in stricter qualifying standards, making students graduating in 2013 attain a 1280 SAT score for a full scholarship – compared to 1270 currently – and 1290, for students the next year.
Those getting 75 percent of their base tuition covered would face new standards a year earlier – needing to score 980 on the SAT in 2012, compared to 970 currently. That level would rise to a 1050 SAT by 2014.
“We don’t know if the House will go along with us,” said Higher Education budget chair Evelyn Lynn, R-Ormond Beach. “But we still have to get a better handle on Bright Futures.”
