U.S. Senate's Medicaid funding vote will help Florida balance budget

The U.S. Senate approved emergency funding on Wednesday for state Medicaid programs, but Florida lawmakers may use much of the state's share to boost spending on other budget areas.

The U.S. Senate voted 62-36 for a bill that includes a $25-billion emergency infusion of stimulus dollars for state Medicaid programs. Congress is proposing the relief in response to the dramatic increases in Medicaid costs as high unemployment has forced more people to seek government assistance.

Florida expects to receive more than $1 billion of the federal Medicaid money, shrinking the state's budget shortfall in 2010-2011 by one-third.

The U.S. House has already passed companion legislation. The two chambers now must reconcile their bills and send a final package to President Barack Obama.

The vote in Washington coincided with the Florida Senate's release of the total amounts it proposes to spend on health care, prisons and all other government programs next fiscal year.

To date, neither the state House nor state Senate has budgeted any additional stimulus dollars that Congress might vote to send to Florida. But on Wednesday, Senate budget chairman JD Alexander, R-Lake Wales, said the anticipated Medicaid funds could be used to increase spending in other areas, like public schools.

"We've got to balance all the needs of the state," said Alexander, R-Lake Wales.

That's what Florida lawmakers did last spring, when Florida received $1.6 billion in Medicaid stimulus dollars. They boosted health care spending by only half that amount, shifting about $788 million in state dollars to other areas.

"After cutting so many services to seniors and disabled and children for two years, it's very insensitive to even think about getting the money and again not using it for the purpose for which it was intended," said, Sen. Nan Rich, vice-chairwoman of the Senate's budget committee on health care.

Rich, D-Sunrise, and Durell Peaden, the Republican chairman of the same budget committee, wrote a letter to Senate President Jeff Atwater, urging that the funds be used to offset health care cuts.

"As you know, critical unmet needs in the health and human services budget can have life-or-death consequences," they wrote. "These needs could be met -- and Real suffering could be avoided -- with these additional funds."

So far, Peaden is the only Republican on his panel who has signed the letter.

"It's not the only part of the budget," said committee member Mike Haridopolos, R-Melbourne. "There are needs in education, in transportation, to make sure criminals stay behind bars. I think we can't make one issue paramount over another; there are just a lot of pressing needs in this state."

Wednesday, Senate leaders proposed spending a total of $6.4 billion in state money on health care and human services. That's $316 million less than proposed by the House. House health care budget chairwoman Denise Grimsley said her allocation still falls about $450 million short of what's needed to continue existing levels of basic services.

Both chambers have demanded that all state agencies propose cuts to their own budgets; in health care, those include deep reductions in mental health and substance abuse treatments. Rich expressed outrage concern over potential cuts to home and community-based elder care, which could force thousands od seniors into nursing homes.

Jaryn Emhof, spokeswoman for Senate President Jeff Atwater, said the chamber has not yet made any final decisions on the use of federal stimulus dollars, trust fund sweeps and other strategies that could ease cuts to some areas.

Justice Cuts

An infusion of federal funds could shift dollars to the state's justice system which, like health care, also gets harsher treatment in the Senate's budget plan.

The Senate would require cuts to courts and prisons of about $285 million, compared with the $141 million in justice cuts proposed in the House.

Sen. Victor Crist, chairman of the Senate Criminal and Civil Justice Appropriations Committee, said the reductions are forcing him to make deeper spending cuts than he'd like to both the Department of Corrections and Department of Juvenile Justice.

Those departments, along with the Florida Department of a Law Enforcement, were chosen for the largest cuts percentage-wise because they were largely spared in the past two years.

Crist, a Tampa Republican, said he hoped to "buy down" about half the $285 million shortfall during conference negotiations with the House.

"We have to reduce those cuts," Crist said Wednesday. "We are too dangerously close to early release (of prisoners)."