From the Palm Beah Post
by John Kennedy
TALLAHASSEE — A budget hobbled by recession-era red ink began taking shape Monday in the state Senate, including proposed cuts to schools, Medicaid and programs used by some of the poorest and sickest Floridians.
With lawmakers facing a shortfall that state economics last week estimated had sunk $3.7 billion deeper, Health and Human Services budget chairman Joe Negron, R-Stuart, praised Senate leaders Monday for designating $28 billion for health and social programs. The allocation will allow budget-writers to maintain some key programs, including funding for homeless, AIDS drug assistance, and the state's KidCare and Healthy Start insurance programs, he said.
But Negron acknowledged that the Senate -- like the House -- plans deep cuts that will affect the state's most vulnerable residents. Both sides are looking to overhaul Medicaid, putting almost 3 million Floridians into managed care programs in a bid to save money while also reducing services.
"We've heard that the current system is irretrievably broken, so we're starting a new system," Negron said.
A Medicaid pilot program operating in five counties since 2006, including Broward, has been derided as a failure by many critics. But Negron said the new program will look nothing like the pilot and will not drive frustrated patients to use hospital emergency rooms -- one of the costliest venues for care.
But the Senate is banking heavily on its high-wire reform effort.
The budget unveiled Monday could effectively pull away any safety nets -- putting added pressure on hospitals by cutting 10 percent of state funding for treating Medicaid recipients. That erases $450 million from the budget.
County health departments also would lose 10 percent of state aid.
Nursing homes, which care for many of Florida's frailest Medicaid patients, would lose 5 percent of their state financing.
The Medically Needy program, an optional program long backed by the state and federal governments, would be sharply scaled back to save $230 million under the Senate budget -- eliminating financial help given transplant patients and other hard-to-insure Floridians.
"We're going to prioritize, we're going to live within our means," Negron said.
Public schools also are on track to take a hit in this year's budget, likely to weigh-in at about $66 billion.
The Senate K-12 proposal also released Monday would reduce per-pupil spending by 6.5 percent - an average $447 less for each of Florida's 2.7 million students.
A big share of the cut -- $739 million -- is pension payments the state will not have to steer toward school districts because teachers and other personnel will be forced to contribute to their pension plans for the first time in four decades.
The House has already recommended a 7.7 percent per-student reduction, while Gov. Rick Scott has called for a 10 percent drop.
"No one wants to go home cutting school spending," said Senate schools budget chief David Simmons, R-Altamonte Springs. But it's looking almost certain this spring.
Sluggish tax collections, stemming from the faltering economy, helped produce the worst budget year in memory. But in addition to that problem came the end of federal stimulus dollars, which had poured $2.5 billion into the state budget this year.
Just hours before Senate budget panels begin work Monday afternoon, House Speaker Dean Cannon, R-Winter Park, did his own bit of budget calculus -- unveiling the levels of taxpayer cash he's allocated to each of the state's big spending categories.
In a memo to fellow lawmakers, Cannon also made some commitments.
Cannon said the House plans to keep $2.2 billion in reserves in its budget proposal to keep Wall Street satisfied with the state's current bond rating, and to have cash on hand if the economy sours more.
Cannon concluded that the House's budget work, expected to begin later this week, will emphasize the "delivery of services to people" over the "purchase of things."
Those labeled purchasers -- and certain to face a tougher time --included environmental, transportation and general government programs.
John_Kennedy@pbpost.com
http://www.palmbeachpost.com/news/state/poorest-sickest-oldest-poised-for-brunt-of-florida-1338050.html
The bill will not "drive people into emergency rooms" because it will cost people who are eligible for medicaid, in other words, extremely poor, to pay $100 to go to ER. Instead they can go to one of the governor's Solantic clinics which will have contracts with the Medicaid HMO companies. Less care, more cost but lots of profits for Scott. Who cares if people die.
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