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New divide in Florida budget debate: the federal health care law

TALLAHASSEE — A new wedge developed Wednesday between legislative Republicans as they hammered out a budget deal: President Barack Obama's health care law.

House health budget appropriations chairman Matt Hudson suggested his Senate counterpart was supporting what conservatives derisively call "ObamaCare" because the Senate plugged $382 million into its proposed budget that dovetailed with some parts of the Patient Protection and Affordable Care Act.

But Sen. Joe Negron said Hudson was misinterpreting the federal law and the Senate's intent. Negron, R-Stuart, said the bulk of the money — $338 million — was to boost Medicaid reimbursement rates for physicians, who have left the program in droves because of stingy spending by the state.

"This isn't ObamaCare," said Negron. "This is paying doctors more."

But Hudson pointed out the federal health act calls for higher physician reimbursements.

"This is certainly not the House position, given everything we're doing to repeal Obama­Care, this is something we're not interested in," he said. "We're not going to implement federal health care in little pieces."

Negron's retort: "Tell the House to pass our joint resolution against ObamaCare. We passed it already. It's sitting over there."

He also pointed out that Obama's health care law calls for higher doctor reimbursement rates in 2013, This money, he said, is for 2012.

And so it went on the first day of joint House-Senate budget conference committees, the tit-for-tat exchange underscoring the politics that play into writing a budget.

In the runup to the bottom-line allocation agreements, the Senate's budget chief J.D. Alexander accused House Speaker Dean Cannon of playing manipulative games. Cannon's budget chief, Denise Grimsley fired back, saying Alexander was erratic in his negotiation style.

In the end, the disputed money probably won't stay in the budget because other senators want to restore services for the mentally ill and drug abusers rather than spend more on doctors.

The cash was placed in the Senate budget earlier this week after tense negotiations between the chambers to make sure they were spending the same bottom-line amount in the different sections of the budget.

Now that the bottom lines match up, the joint committees are reconciling the finer spending points.

It's a numbers game: The Senate justice budget is $36 million higher than the House's, because the Senate applies a cost-savings number to new privatization ventures in the prison system, but the House does not.

The health budget, though, is the most troublesome because it's so large. The Medicaid program alone costs $22 billion and is the biggest chunk of the state's more than $67 billion budget.

The Senate announced it would reduce the size of a cut to help sick transplant patients in the Medically Needy program, but the House said the Senate is still skimping on care. So they found no agreement there.

At this point, few services will be spared a cut because of the size of the nearly $4 billion budget hole.

The Democratic leader in the Senate, Nan Rich of Weston, said that, with so many needs, the Republicans who run the Legislature should have considered closing tax loopholes to fund more programs. She said the Wednesday flare-up over Obama's health law made no sense.

"This isn't about federal health care," Rich said.

Senate President Mike Haridopolos, sponsor of the state plan to fight the federal health care law, dismissed the House claim about his health budget.

"That's the first I've heard of that," he said.

Times/Herald staff writer Steve Bousquet contributed to this report.

New divide in Florida budget debate: the federal health care law 04/27/11 [Last modified: Wednesday, April 27, 2011 8:55pm]
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