By John Kennedy
The News Service of Florida
The U.S. Senate’s $15 billion jobs bill positioned for a vote this week no longer offers any hope for Florida Gov. Charlie Crist’s effort to patch up a gaping hole in state Medicaid spending.
When Crist proposed his $69.2 billion state budget last month, he included $1.2 billion in extra Medicaid funding anticipated to flow to Florida from what at the time was seen as bipartisan support for the jobs package.
But within a couple weeks of Crist’s budget presentation, the Medicaid provision was eliminated from the legislation advanced Monday when five Republicans, including new Massachusetts Sen. Scott Brown, joined Democrats in ending a filibuster that had stalled the measure. A final Senate vote on the bill may occur as early as Wednesday.
Meanwhile, the Medicaid measure is languishing.
“We’re not in a position yet where we’re going to give up on the funding,” Crist spokesman Sterling Ivey told the News Service of Florida on Tuesday. “We realize that as we move into session, we may need to re-evaluate where we go with the state budget. But anything can happen in Washington.”
Crist was among 47 governors who wrote congressional leaders this week urging that the so-called enhanced federal match for Medicaid (FMAP) be extended for six months into 2011. Florida is in line to spend $4.4 billion in extra federal Medicaid money in the three years ending Dec. 31 – but the $1.2 billion the FMAP extension could bring would help carry the state’s troubled health-care program through the budget year ending in June.
“Unfortunately, the length and depth of the recession means states and territories will continue to face significant budget shortfalls long after the enhanced FMAP provisions expire at the end of this calendar year,” the governors wrote in their letter.
Crist was criticized by many lawmakers for rolling the expected Medicaid money into his budget, which he also supplemented with $434 million from a Seminole Tribe gaming compact that remains unresolved.
But Crist defended the FMAP move by pointing out that the 6-month extension had been included in the U.S. House’s jobs bill approved in December, and would likely be revived in a Senate jobs package.
As the Senate package was finalized, however, it was also scaled-back in an effort to win Republican support. The FMAP provision was eliminated, although even if the Senate fails to approve some form of Medicaid funding, the extension could be revived in House-Senate negotiations.
But with budget-writers in Florida facing a $3.3 billion shortfall – more than half of it coming from Medicaid costs, alone – the FMAP financing is considered critical. While the Medicaid enhancement has fallen out of the jobs bill, it has been made part of legislation advanced by Sen. Jay Rockefeller, a West Virginia Democrat, and Senate Majority Leader Harry Reid, D-Nevada.
While governors supporting the funding are a bipartisan mix, the FMAP funding now risks being portrayed chiefly as a Democratic initiative in a sharply divided Washington, said some of those closely following the dollars.
“There is a sentiment among economic forecasters that without the FMAP funding, a big drag will be created on the economy across most states,” said Nick Johnson, an analyst with the Center on Budget & Policy Priorities, a Washington, D.C., nonprofit. “But it’s really anyone’s guess about where things are going in Congress right now.”
In Florida, fear cuts across political lines over what happens to the $19 billion state-federal Medicaid program — on track to serve 2.7 million low-income residents – without the 6-month extension of federal aid.
“If we don’t get FMAP, they’ll mutilate Medicaid,” said Karen Woodall, who lobbies on behalf of children’s programs and low-income Floridians.
She warned that such costly – but not mandatory Medicaid programs as the state’s Medically Needy initiative, which provides health coverage for 24,000 critically ill Floridians, could be eliminated.
Sen. Don Gaetz, R-Niceville, a member of the Health and Human Services budget committee, said that if FMAP dollars don’t continue into next year, Medicaid budget-cutting is a certainty.
“When you have a $3 billion budget hole, and health care is one-third of your spending, you’re looking at some significant challenges already,” Gaetz said. “But without FMAP, every optional program will be examined carefully.”
