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March 11, 2008 The Legislature is in budget-cutting mode and, unfortunately, Florida's most vulnerable are at risk. Medicaid serves poor children, the disabled and elderly. The federally supported program is targeted because it is one of the state's biggest expenses. So, not looking at Medicaid spending would be ill-advised. The trick is to find cost savings without cutting critical services. Cutting the Medicaid budget across the board as the state Senate proposes, however, would imperil vital services and shift costs to local communities. Miami-Dade and Broward counties would suffer most because we have the largest Medicaid populations in the state. South Florida lawmakers should fight the sweeping cuts. The Legislature should look at selective pruning and other proposals to raise revenues, such as lifting sales-tax exemptions and closing corporate income-tax loopholes. Proposal may resurface One good sign came last week when the Senate approved $500 million in cuts to the current year's state budget. Senators wisely rejected a proposal that would have indefinitely frozen Medicaid rates. However, the proposal is likely to resurface when legislators consider next year's budget. The rate freeze would shave an estimated $316 million from Medicaid payments to nursing homes, hospitals and other healthcare providers by eliminating rate hikes calculated to cover inflationary costs. Such a cut will hurt nursing homes, which have been hit with repeated rate cuts over several years. Other targets include Medicaid-paid eyeglasses, dentures and hearing aids for nursing-home patients. Hospitals and doctors also will get less, and likely charge private patients more. Medicaid already pays doctors low rates, only 65 percent of what Medicare pays. This is unacceptable when compared to low-paying states such as Georgia (81 percent) and South Carolina (89 percent). It explains why many Medicaid patients have trouble finding doctors. Declining health House Speaker Marco Rubio's proposal to expand the troubled Medicaid reform project into Miami-Dade is another bad idea. The state doesn't even know whether it is saving money. This unworthy proposal should be quashed. Add to state cuts the threat of federal Medicaid funding losses, and Florida could have a healthcare crisis. Some will pay with declining health. Others will end up in emergency rooms, and local taxpayers will end up paying the tab. Florida needs a better Medicaid system, but cutting vital healthcare services will only increase the pain for everyone.
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