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House releases health care budget with no supplemental funds and deep staff cuts at Dept. of Health

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The House released a health care budget on March 17 that contains no supplemental Medicaid dollars traditionally used to help pay hospitals, federally qualified health centers, graduate medical education and even prepaid health plans.

House Health Care Appropriations Subcommittee Chairman Rep. Matt Hudson said it would be “premature” for the House to include supplemental, or Low Income Pool, dollars in the budget given the fact the federal government has not approved the continuation of the program beyond June 30.

Nevertheless, Hudson told the committee that despite the lack of supplemental dollars, “No category of Medicaid eligibility is eliminated or reduced and no provider rates are reduced.”

Hudson said when the state receives more definitive information from the federal government the House will update its budget.

“We hope to have resolution before the end of the session,” Hudson said as he discussed the initial proposed budget, which for the Agency for Health Care Administration totals about $22.8 billion, or about 7 percent less than AHCA’s current budget. The health care budget also has allocations for the other health care-related agencies in the state:

  • $1.16 billion to the Agency for Persons with Disabilities
  • $2.97 billion to the Department of Children and Families;
  • $293.5 million to the Department of Elder Affairs;
  • $2.78 billion to the Department of Health; and
  • $108.5 million to the Department of Veterans Affairs

While the AHCA budget does not include any federal dollars for Low Income Pool it does include the dollars the counties contribute to the state to drawn down the federal LIP dollars.

The elimination of the LIP dollars appears on the House spreadsheet as a $1.9 billion reduction  “as agreed to” by the Social Services Estimating Conference.  State economists agreed at a March meeting to eliminate LIP from future Medicaid expenditures because it expires at the end of this fiscal year and no agreement to replace it is in place.

Hudson’s budget isn’t all about reductions, though. Among other things, he proposed giving AHCA an additional $1.7 million to fund a 3 percent increase in reimbursement rates for private duty nursing services, $250,000 for the developing a prospective payment system for hospital outpatient services and $250,000 for developing a prospective payment system for nursing homes.

Hudson’s proposed budget does have staff reductions to the health care agencies. He eliminate nearly 600 positions existing positions from the Department of Health and another 219 vacant positions. The Agency for Health Care Administration is targeted to lose 81 positions.

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