As legislative leaders struggle to reach agreement on a state budget, proposals to slash Florida’s Medicaid spending by hundreds of millions of dollars have emerged as a key point of contention.

  • House Republicans want Medicaid budget cut by $621 million
  • Senate Republicans want Medicaid budget cut by $258 million
  • Nurses say the more that’s cut, the more it hurts the patients
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House Republicans are calling for the Medicaid budget to be cut by $621 million, dwarfing the Senate’s $258 million cut. The disparity is contributing to a cross-rotunda impasse that threatens to throw the legislative session into overtime.

While they disagree on the size of the cuts, the legislature’s Republican leaders are generally united in their desire to slow the growth of Medicaid. The program, they argue, has become bloated as a result of the rates charged by doctors and hospitals that serve Medicaid patients.

That charge, in particular, has drawn the ire of Medicaid providers that maintain their rates are, if anything, too low. Government-dictated Medicaid fee schedules determine the program’s payouts, and many providers say the state needs to increase Medicaid spending, not slash it.

“The more you cut, the more it’s going to impact and the more it’s going to hurt these patients, and the fewer patients that are going to receive the benefits that they need,” said Kimberly Lewis, who was among a group of nurses advocating against the cuts at the Capitol Monday.

In addition to their concerns about the way Medicaid is being run, however, Republicans are pointing to another reason for cutting the program: the state’s bank account. Amid declining tax revenues, trimming Tallahassee’s spending silos — not least among them the health care budget — in order to avoid a deficit has become an imperative, if difficult, exercise.

“Those things matter, that we have that kind of longevity and stability in our budget,” said House Speaker Richard Corcoran (R-Land O’Lakes). “And so, that requires shrinking the budget and making sure you put a certain amount of money in reserves.”

But critics argue reducing health care spending isn’t a zero sum game. If Medicaid patients — especially those who rely on the program for specialized treatment of chronic illnesses — lose some or all of their coverage, taxpayers could have to foot a much larger bill for uncompensated care.

“A lot of the conditions are genetic, so some families, they may have more than one child that has this disease — like sickle cell disease — they may have three or four children that are affected by that, and there’s just no way that they can possibly contribute to that without having the Medicaid funding,” Lewis said.

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Nurses fight planned cuts to Florida Medicaid