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Congress eyes cuts to Medicaid and Medicare; Florida braces for the fallout

By Lynn Hatter

http://stream.publicbroadcasting.net/production/mp3/wfsu/local-wfsu-976867.mp3

Tallahassee, FL – The deadline for Congress to raise the federal debt limit or risk a default is drawing closer and programs that have been sacred in the past are on the chopping block. Medicaid and Medicare are among them. The health insurance programs for the poor and elderly have been targeted for billions in federal cuts. Lynn Hatter reports a coalition of groups is building to stop what they say are potentially harmful cuts in programs that a large amount of Floridians depend on.

Congress is considering eliminating Medicare payments to hospitals to cover debts when people don't pay. It's also looking at scaling back payments to teaching hospitals, and reducing the federal share of Medicaid assistance to states to cover low-income people.

"Specifically, here at Brynwood, it's approximated to be 294-thousand dollars annually."

That's Lisa McKinley. She's a nursing home administrator at Brynwood Center in Monticello, Florida, and she's worried about federal proposals to cut Medicaid and Medicare.

"This comes on the tails of prior Medicare cuts. And we're asking if legislators and lawmakers would be cognizant of the outright havoc this will cause in our skilled nursing facilities."

Medicaid covers low income people, and is jointly administered by the state and the federal government. Congress is looking at cutting its share of the program by 100-billion dollars over the next decade. That comes after Florida lawmakers reduced Medicaid funding as a result of state budget cuts. The Florida Healthcare Association, which lobbies for the state's nursing home industry, says they could get dealt a double blow. The association's Tony Marshall says any reductions made to Medicaid will affect the state's share of the program as well.

"And so when you put them together, it just makes such a large reduction that it just creates significant financial instability."

One way to make up cuts is to cut employees, the skilled nurses who care for residents. That's something nursing homes don't want to do, and they are keeping an eye on the deficit debate in Washington. The Florida Hospital Association is watching too. It's concerned about the other healthcare entitlement program- Medicare, which covers seniors. State hospitals get about half their income from Medicare. And Association President Bruce Rueben says if the proposed spending cuts go through, it would result in higher premiums for people with insurance.

"You're talking about unmet costs, not profit or extra revenue. And that unmet cost has to be covered or else the hospital can't continue to provide services. Each time these cuts are made, the unmet costs become a hidden tax on those with insurance."

The reason hospitals, nursing homes and other healthcare groups are watching the debate in Washington so closely is simple: People in Florida are getting old. According to the last census, more than a third of residents are 55 or older. There are almost three-million Floridians on Medicaid. And almost 10-percent of the population is uninsured. Bruce Rueben:

"So when they cut Medicaid and Medicare in a state like Florida, with so many people on those programs, we have a much bigger impact here than in a state where you have a younger population or you have fewer uninsured."

The left-leaning Public Policy Polling Institute released a survey showing 40-percent of Floridians are opposed to the more drastic proposals to the programs like requiring co-pays from Medicare recipients or turning Medicaid into a block-grant program for states. Florida's congressional delegation has been vocal about the issue. Senator Marco Rubio couldn't be reached in time for this story, but in a pre-recorded address, Rubio says it's a perfect time to address the nation's long-term issues.

"We have entitlement programs that are going bankrupt, and I want to save these programs, like Medicare and Social Security. I'm for saving these programs, but to save them, we have to reform them. If we leave them the way they are now, they're going to go bankrupt."

Cutting the nation's entitlement programs is deeply unpopular with most Democrats just as tax increases are with Republicans, but both options have made their way into the debate as the sides inch closer to a deal on cutting the budget, raising the debt- limit and hopefully, avoiding a default on that debt.