When the Florida Legislature officially begins meeting March 2, lawmakers can demonstrate our state’s commitment to a strong and vital health care delivery system. Among its items for the 60-day session is the budget to govern state spending for 2021-2022. Funding the state’s Medicaid program, a critical safety net program serving nearly 4.5 million Floridians, without cutting payments to hospitals and other providers is key to that commitment.
Governor Ron DeSantis released his proposed state budget in late January. While those recommendations are not directives to state budget writers, they are an indication of the Governor’s priorities for state tax dollars. The Governor’s budget proposal makes clear that health care is chief among his priorities.
The pandemic will exact a prolonged economic toll on Florida and require sustained investment in the health care workforce, infrastructure, preparedness, and continued health care coverage. The Governor’s budget proposes no cuts to the state’s health care programs, particularly Medicaid, the health care coverage program for low-income parents and children, individuals with disabilities, and the elderly. Indeed, his recommended 2021-2022 state budget includes a 17 percent general revenue increase to fund the state’s Medicaid program to cover the increased costs largely as a result of an increase in enrollment of over 750,000 due to the economic downturn in our state. More than 4.5 million Floridians rely on Medicaid for health care, a number that increased 20 percent over the course of the pandemic as job losses mounted, and families lost access to employer-provided health insurance coverage.
Along with increased unemployment, the pandemic’s impact on the economy also resulted in decreased sales tax collections. With greater need for government services but less revenue, state budget writers have difficult choices to make because not every funding need can be fully met. Going into budget discussions this year, lawmakers must contend with a deficit of over $2 billion, including a projected $1.2 billion shortfall in general revenue for Medicaid.
The challenge for lawmakers is that, unlike the federal government, the state’s budget must be balanced. By law, there can be no deficit in any state fund. This balance requires tough choices.
Prioritizing health care funding in the budget is not about prioritizing buildings or facilities. Hospitals, clinics, and long-term care facilities are nothing without the people within them – the individuals who deliver care and compassion every day. Prioritizing health care funding in the budget is about prioritizing the contributions of the hundreds of thousands of physicians, nurses, aides, therapists, and others who daily endeavor to heal wounds, restore function, alleviate pain and suffering, and repair what was broken. It is also about prioritizing a health care infrastructure to ensure that it is always ready, always available, and always capable of responding to any emergency or crisis, whether it involves one person or many.
The pandemic has shone the brightest of spotlights on the need for a strong, always-ready health care system. Being ready and responsive 24-hours a day, seven days a week carries major costs, many of which are not immediately obvious to the casual observer. These include around-the-clock staffing of highly trained professionals; an array of equipment, supplies, and medications on standby; and the ability to add surge capacity to meet higher-than-usual need for care.
A budget, whether for a household or a government, reflects choices and priorities. Florida’s hospitals and the tens of thousands of individuals who give meaning to hospitals’ work are relying on state lawmakers to follow the Governor’s lead and prioritize health care.
