TALLAHASSEE — After weathering back-to-back budget cuts, Florida hospitals now face a $137-million reduction that could soon put the state's health care system into crisis and lead to the closure of some facilities, according to hospital officials and even one of the legislators tasked with slashing health care spending.
"I don't think the hospital system can take any more," said Republican Sen. Durell Peaden, a Crestview doctor who heads a health budget committee.
"After this year," he said, "you could see some closures if there are more cuts, especially with rural hospitals."
Already, Alachua General Hospital closed its doors in the Gainesville area, and advocates fear the state's two children's hospitals are also at risk.
All Children's Hospital in St. Petersburg is bracing for a $4.5-million reduction, and Miami Children's Hospital faces a $5-million cut, according to an analysis by the Florida Hospital Association and the Safety Net Hospital Alliance of Florida.
About two-thirds of the children's hospital money comes from Medicaid, a state-federal health insurance program that the Legislature is cutting to fill a $2.4-billion budget hole during the special session that ends next week.
The hospital cuts won't go into effect until spring, when legislators return for the regular session to hash out next year's budget.
That budget already has a projected deficit of about $4-billion.
The likely outcome: more reductions. Hospitals — as well as nursing homes and Medicaid health maintenance organizations — say they can't take much more. If the most recent round of cuts is approved, hospital reimbursement rates will have been slashed by a cumulative 12.6 percent after 18 months of budget cuts.
"The children's hospitals are facing serious problems," said Tony Carvalho, who lobbies for the Safety Net Alliance, which represents the children's hospitals and other charity-care facilities from Tampa Bay to South Florida.
"I don't want to say they're facing closures," he said. "But this is serious."
The hospitals' budget numbers differ slightly from legislative figures because they include the impact of Medicaid HMO cuts and other complicated rate reimbursement calculations.
Hillsborough, Pinellas, Pasco and Hernando hospitals face respective cuts of $9.6-million, $8.3-million, $864,000 and $396,000.
On Wednesday, House lawmakers signed off on the cuts when they approved about $1-billion in reductions affecting everything from roads to schools to health care to affordable housing.
The full House votes on its budget today, when the Senate's full budget committee takes up its proposal, which includes an unexpected cut of $20-million for the Florida Forever program.
As they have in committees, Democrats will likely vote against the Republican budget proposals, which seek to avoid tax increases.
House lawmakers Wednesday also emptied savings accounts and tentatively signed off on gutting the Lawton Chiles Endowment, an annuity that funds health care for seniors and children. In the House, lawmakers agreed to transfer about $400-million from the fund and then another $600-million if need be. The fund has just $1.1-billion left.
The son of former Gov. Chiles, Bud Chiles, has threatened to sue the state if it empties the fund named for his father. He wants lawmakers to raise cigarette taxes and close tax exemptions.
"They're like deer in the headlights," he said. "They're frozen. But they won't do the right thing."
Marc Caputo can be reached at mcaputo@MiamiHerald.com.
[Last modified: Jan 11, 2009 04:37 PM]
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