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Friday, May 25, 2018
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A health care money grab

It is small comfort that the Florida Legislature swiped only $45 million of health care funds from Hillsborough and other urban counties, instead of the $245 million that it had originally intended to take. The number may be lower, but the Legislature still pilfered money from counties that use local tax dollars to help the poor. It is a dangerous precedent. You can be sure that there will be efforts in future sessions to increase the amount that is diverted to counties that contribute nothing to help treat the poor. As we explained in an earlier editorial, under current law a community can send local tax dollars to the state government in order to increase Florida’s federal Medicaid match. State officials send the additional federal funds that were made possible by the local contribution — along with the local dollars — back to the contributing county.
For instance, last year Hillsborough sent $54 million — a portion of the revenue collected from its half-cent indigent health tax — to the state for the federal Medicaid match, which earned an additional $77 million in federal aid. Both the $54 million and $77 million were sent to Hillsborough. Hillsborough and 26 other counties are willing to use local tax dollars to bolster the state’s federal match because Medicaid pays far less than the costs of treatment. Increasing the federal funds sent to the county reduces the local shortfall. Unfortunately, the state Senate saw the local health care tax dollars as cash for the taking. Senators launched a plan to take 45 percent of the federal matching funds generated by the local tax dollars and distributed them to a statewide pool, so much of the money would have gone to counties who had done nothing to increase the federal match. Fortunately, the House firmly opposed the scheme and the final budget agreement included only a 10 percent diversion on Medicaid reimbursements for hospital visits. Hillsborough, instead of losing $15 million as it would have under the original plan, now will lose about $2.2 million. Tampa General, which would have lost $7.4 million, will lose about $1.2 million. That is an improvement — but $2.2 million would cover a lot of health care. Because the funding formula does not include specific allocations, the governor cannot veto it. The message of this formula is as offensive as the diversion of tax dollars. Counties such as Hillsborough that had the vision and discipline to adopt local funding plans for health care needs are being forced to subsidize communities that were not as responsible. So much for fiscal accountability. Now that the Legislature has started this money grab, it’s a virtual certainty that lawmakers will seek to tap more each year. The House deserves credit for trying to minimize the damage this year, but Hillsborough’s delegation needs to be prepared to aggressively fight this scheme again next session.
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