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Saturday, Dec 15, 2018
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Editorial: The ‘safety net’ has holes

The Florida Legislature appears intent on hijacking health funds from Hillsborough and other counties that have been proactive in meeting their health-care needs, while also undermining the state’s vital “safety net” hospitals.

House Speaker Will Weatherford and Senate President Don Gaetz should recognize the inequity of this health-care funding scheme.

The matter is convoluted, making it easier for state lawmakers to pull off the money grab.

As the Tribune’s James L. Rosica found, when the Legislature went to a Medicaid managed-care system in 2011, it adopted a new funding formula that becomes effective July 1.

The problem is the system uses tax dollars collected locally to generate funds that are redistributed throughout the state, including communities that have not bothered to address their own health-care needs. Hillsborough, for instance, adopted a half-cent indigent health-care tax in 1991 to help low-income residents.

Hillsborough County Commissioner Sandy Murman is on target when she says the local dollars “shouldn’t be used to assist other communities that didn’t have the political foresight to provide for the care of their most needy residents.”

The plan would be particularly damaging to children’s hospitals, cutting more than $100 million from their budgets, and the teaching-safety net hospitals, such as Tampa General, that treat the neediest patients.

The funding formula will hurt local hospitals. Tampa General would lose $43 million. St. Joseph’s Children’s Hospital of Tampa would be cut an estimated $14 million.

As the Safety Net Hospital Alliance of Florida points out, the state’s 14 flagship teaching, children’s and public hospitals would lose nearly $302 million of the $567 million in funding cuts or reallocations in this plan.

Some background: Communities that raise tax dollars for health care traditionally have sent a portion of these local dollars to Tallahassee in order to increase the state’s federal Medicaid match. In the past, the state would send the additional federal dollars that result from a county’s contribution back to the donor county.

Medicaid pays far less than the cost of treatment, so increasing the federal funds sent to a county reduces the local shortfall.

But last year the state began reallocating a portion of the increased federal match to other communities, including to for-profit hospitals. As we said when the Legislature initiated this shift, counties that had the vision and discipline to adopt funding plans for health care needs are being forced to subsidize communities that were not as responsible.

Now the funding formula scheduled to take effect this summer would increase the amount of funds swiped from Hillsborough and other donor counties.

Moreover, as the Safety Net Hospital Alliance points out, the funding formula allows the state to hand over local public health funds to private health maintenance organizations, sacrificing oversight of the local tax dollars.

Lawmakers would be howling if Washington attempted such a scheme. They don’t seem to mind when they get to redistribute the funds.

Weather Center