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Florida worries about a bursting budget under federal Medicaid expansion

By Lynn Hatter

http://stream.publicbroadcasting.net/production/mp3/wfsu/local-wfsu-991280.mp3

Tallahassee, FL – The state of Florida is growing increasingly concerned about 2014. That's when about two-million more Floridians will become eligible for Medicaid under federal rules. Lynn Hatter reports the state says the new enrollees will add to the state's budget problems.

Under federal rules a family of four has to earn less than 30-thousand a year to qualify for Medicaid. States can adjust that number. So in Florida, that same family couldn't earn more than 18-thousand. State Medicaid Director Justin Senior says when the federal government's healthcare overhaul law fully kicks in, Florida could see up to 1.5-billion dollars more in costs as an estimated two million more people become eligible for Medicaid.

"That one, to 1.5 billion dollars would include rate increases for physicians. The bill as its currently drafted contemplates raising those rates to the Medicare rate nationwide and in Florida it would add several hundred million dollars to the cost of the Medicaid program."

Florida can't afford the Medicaid recipients it has now. Even though the federal government would cover the initial costs of the expansion, state's would eventually have to pick it up. Florida expects a two-billion dollar budget shortfall next year, and half of that comes from Medicaid. In a legal document filed Monday, Florida and the rest of the states challenging the federal affordable care act, are arguing the Medicaid expansion is also unconstitutional.

Meanwhile, the Florida Agency for Healthcare Administration has to cut its budget by 10-percent. AHCA's finance director Phil Williams says that's going to be hard to do.

"These are issues that we know are hard to grapple with and whether they can actually implement them is a real question."

About 70-percent of the agency's budget is in services and that's where the cuts come in. The agency has proposed eliminating adult dental, vision hearing and podiatry care, along with limiting the number of emergency room visits and doctor's visits. Critics of those proposals say the cuts amount to rationing care.