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Castor: State Leaders Playing Shell Game with Florida's Medicaid Money

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U.S. Congresswoman Kathy Castor, D-Tampa

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Tallahassee, FL – As the Legislature crafts its budget, Congresswoman Kathy Castor and others are calling on the state to spend its share of one billion dollars in federal Medicaid money solely on health and human services. But as Margie Menzel reports, the governor and legislative leaders may have other plans.

Florida expects to receive about $1 billion from the federal government - roughly one-third of its total budget shortfall. The money is coming because Congress is extending for six months its Medicaid reimbursement rate, known as the Federal Medical Assistance Percentage, or FMAP, to Florida. But Congresswoman Kathy Castor, Democrat of Tampa, says state leaders are complicating matters.

"Unfortunately, the Florida Legislature - the leadership there is making it very difficult to fight for those extra resources for health and human services, especially the most vulnerable population that relies on Medicaid," Castor said.

The state Senate, for instance, now plans about $1 billion in cuts to health and human services, including children, pregnant women, seniors and people with disabilities.

"We have about $1 billion dollars that we're building consensus for up here in Washington," said Castor, "but we feel undermined by state legislative leaders that are saying they're not going to use that - those resources for the intended purpose."

The FMAP extension increases federal funds to Florida thanks to a higher Medicaid reimbursement rate.

"Well, we have every intention of using the FMAP money for FMAP."

Senate budget chief J.D. Alexander, Republican of Lake Wales.

"Whether or not some other funds within the HHS appropriations area might be otherwise used - we just have to take a look at it," Alexander said. "Our job is to meet all the critical needs of the state within what's right and proper to do, and we will try to make a balanced set of decisions meeting all of our needs."

Alexander says the federal government would require the state - if it accepts the FMAP extension - to maintain roughly a quarter of a billion dollars' worth of health and human services programs otherwise marked for reduction or elimination.

"It's about $740 million net that would be available," Alexander said. "Hopefully we'll keep the majority of that in HHS, and of course, all of it will be used for Medicaid, but it may allow us to use less general revenue to backfill that gap."

Castor says the process reminds her of the lottery.

"The shell game that they're playing right now with health and human services dollars, it reminds me of the lottery of some years ago when they promised that those monies would be extra, added on top of education for our students and teachers," she said. "Instead, they supplanted other money - they supplanted other parts of the education budget. That's exactly what's on the table now."

Senate President Jeff Atwater, Republican of North Palm Beach and candidate for Chief Financial Officer:

"I think that maybe she would be unfamiliar with where we're at in our process."

Atwater wrote to U.S. Sens. Bill Nelson and George LeMieux in November, saying the FMAP rate was based on an unfair formula that needs to be corrected.

"Hopefully, Congress would decide that they will continue to pick up their existing proportionate share of this mandate," Atwater said. "And if they would do that, then I think we'd be able to meet, you know, significant needs that it sounds like she's concerned about. So if they would get on and make their decision - this has been before them for months. So if they'd get on and make their decision, maybe the conversation here could get on with settling our budget."

Castor agrees. She wrote to U.S. House Speaker Nancy Pelosi in January, urging Congress to correct Florida's FMAP allocation. A spokesman for Gov. Charlie Crist Friday said the FMAP extension will be used wholly within the Medicaid program. Wrote Sterling Ivey in an email, "The Governor supports using these freed up dollars to mitigate cuts in health and human services, public safety and education, and to provide the possibility of tax relief for families and businesses and incentive to spur economic development."