Doctors and hospitals treating Florida's poorest patients face significant pay cuts in the state's nearly final budget.
Legislators will vote by Friday on a $70 billion budget that includes $304 million less to reimburse hospitals. A Florida Hospital Association analysis released Wednesday projects the state's hospitals will receive $323 million less for treating poor children, pregnant women and disabled adults in 2013.
This second consecutive year of Medicaid cuts will force hospitals to quickly decide what services to reduce or eliminate, said Kimberly Guy, chief operating officer at St. Joseph's hospitals for women and children, where the cuts could total $7.3 million.
"It's an incredible task to even begin thinking about," she said of cuts that will disproportionately affect the 186-bed St. Joseph's Children's Hospital in Tampa.
The 19 hospitals in Hillsborough and Pasco counties face more than $28 million in lost reimbursements, the hospital association report shows. The losses stem from overall cuts to Medicaid and new limits to the number of times an adult can visit emergency rooms.
Tampa General Hospital is projected to receive $10.6 million less next year, the fifth-largest cut among all state hospitals. The H. Lee Moffitt Cancer Center and Brandon Regional Hospital could see smaller cuts of about $2.3 million each.
Statewide, 3 million poor and disabled Floridians receive Medicaid, about half of whom are children. The state is responsible for administering the program supported by a combination of federal, state and local money.
Medicaid is a costly and growing program, and Florida law requires legislators to pass a balanced budget. That situation and an expected $2 billion drop in tax revenue make cuts inevitable, Gov. Rick Scott said.
"We have to deal with the fact that Medicaid is growing so fast," Scott said Tuesday in Tallahassee.
The proposed budget also is void of $438 million in federal Medicaid money to reimburse physicians. Scott has declined that money and millions more as part of his legal challenge to the national Affordable Care Act.
Many in the GOP-led Legislature support the governor's decision.
"It's Affordable Care Act dollars, and we're not taking them," House Health Care Appropriations Chairman Matt Hudson, R-Naples, told the News Service of Florida.
On Wednesday, U.S. Rep. Kathy Castor, D-Tampa, urged legislators to reconsider. The money would help increase payments made now to primary-care physicians and pediatricians who treat the poor, she said.
The cost of treating a Medicaid patient in Florida today is more than the state reimburses, said Louis St. Petery, a pediatrician and executive vice president of the Florida Chapter of American Academy of Pediatrics.
The $438 million represents less than 5 percent of the state's overall Medicaid funding. He says that without this assistance, treating children with Medicaid is a losing proposition.
"The doctors are being asked to donate to the state of Florida," St. Petery said during a conference call with Castor and reporters.
Rejecting federal money for Medicaid in today's economic environment is especially tough, said Guy, the St. Joseph's administrator.
"We do feel like we've been hit on both sides," she said.