Florida hospitals serving poor patients may lose millions in state budget

TALLAHASSEE — Some of the state hospitals that serve the poorest and sickest patients are likely to see millions in cuts, the Florida senator in charge of crafting the state’s health care budget said Wednesday.

Hospitals that take on the largest number of Medicaid patients have for years received hundreds of millions in extra taxpayer funding. For instance, in 2021, the state distributed $309 million to support 28 of those facilities as part of what hospital administrators call the “critical care fund.” Some of the biggest beneficiaries have included Jackson Memorial Hospital, two Broward Health facilities, Johns Hopkins All Children’s Hospital in St. Petersburg and Tampa General.

Although Medicaid reimbursement does not cover the cost of care offered by hospitals, Republican leaders argue the additional state money is no longer needed because of other government funding at facilities’ disposal.

Florida hospitals got billions in federal relief money during the coronavirus pandemic, they argue. And a program launched last year called the “directed payment program” has netted hospitals more than $1 billion so far. Under that program, local governments tax hospitals, then use that money to draw down matching federal dollars. Hospitals then use both the tax money and the federal money to cover the cost of Medicaid care.

“It may be time to say goodbye to the critical care fund,” said Sen. Aaron Bean, R-Fernandina Beach, who is leading the Senate side of budget negotiations. “Times change. We’re taking advantage of federal programs.”

The cuts could come at a time when Florida has a record number of its citizens enrolled in Medicaid, the state and federal health insurance program that covers disabled Floridians, some elderly adults, children and new or prospective mothers. Since the beginning of the pandemic, Florida has not kicked anyone off of its Medicaid rolls, which have swelled to include a record 5.1 million people.

But even if they cut the critical care fund, lawmakers could still use other budget areas to funnel extra money to hospitals that see lots of patients enrolled in Medicaid. For example, a Senate budget proposal released Wednesday would direct nearly $85 million in additional taxpayer funds to children’s hospitals.

Some hospitals wouldn’t lose out on their usual share of Medicaid dollars even if critical care dollars dry up.

Tampa General, St. Joseph’s and Johns Hopkins All Children’s are in line to get nearly $51 million in enhanced funding from the state, a figure in line with what they would receive from the “critical care fund.” (Those facilities are not benefiting from the federal money drawn down by the directed payment program.)

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Budget negotiations are not over. The two chambers still have major differences on how to spend more than $14 billion in state general revenue. The House and Senate are scheduled to come together on a final proposal next week.

Mary Mayhew, president and CEO of the Florida Hospital Association, said she’s holding out hope the state won’t take extra Medicaid money away from hospitals that serve the greatest number of poor patients.

“Now is not the time to be cutting health care,” Mayhew said.

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