The fiscal 2011-2012 budget is set to be adopted Friday, the final day of the regular legislative session, along with a comprehensive overhaul of Florida's Medicaid program.
A deal on the $69.7 billion budget was reached earlier in the week, and the state Senate prepped a compromise Medicaid reform bill with the House Thursday.
Those two issues, which Sen. Dennis Jones, R-Seminole, a 30-year veteran of the Legislature, last week said helped to define the session, will have to wait until the 60th day before being fully addressed by the Legislature.
Many legislators have described the budget process as the toughest in recent memory, as they look to cut nearly $4 billion to make up a budget shortfall. Significant cuts to education, Medicaid, and state worker compensation are included in the budget.
Lawmakers are poised for the end to the session with a late night, as the final budget was not ready for members until 10 p.m. Tuesday, and state law requires 72 hours for review before it can be voted upon.
One of the largest parts of the budget is the Medicaid program, which currently swallows up 30 percent of the budget. Its funding for the coming fiscal year is $22 billion, and proposed Senate cuts to Meds-Ad and Medically Needy, two Medicaid programs, had held up budget negotiations until an agreement was reached to fund them as the House wished.
The House and Senate also haggled over provisions in the Medicaid reform package, which will transition recipients into managed-care plans over the next two years.
Weve really given flexibility to the individual whos receiving Medicaid benefits to make choices that are the best for them and their family, said Joe Negron, the Senates point man on Medicaid reform.
The bill is based largely on a pilot program in Broward County and four other North Florida counties that increased the role of managed-care companies.
Sen. Eleanor Sobel, D-Hollywood, expressed concern that health management organizations (HMOs) would abandon Medicaid patients, as many did in the pilot program, and provider service networks (PSNs), which are comprised of some nonprofit hospitals, would be unable to pick up the slack.
Were supposed to learn from pilot programs. Why didnt we accept the successes of the PSNs and the Medicaid pilot program? Sobel said.
Under the bill, PSNs would have two years to transition from a fee-for-service model to a contract obligation model for providing health care services.
I think the bill goes out of its way to give PSNs every opportunity to succeed, said Negron.
The bill also caps non-economic liability damages for Medicaid recipients at $200,000 for individuals and $300,000 per incident.
The reform package has been a top priority of Senate President Mike Haridopolos, R-Merritt Island, who vowed to impose cost controls on Medicaid while improving health care. The program's costs are projected to increase exponentially with the imposition of the Affordable Care Act, or Obamacare, which increases the amount of people eligible for Medicaid. In Florida, between 1.4 million and 1.7 million people could be added to the Medicaid rolls when many of Obamacare's provisions take effect in 2014.
Many of the provisions of the Medicaid reform package require a federal waiver to be implemented.
"I don't think we should allow Washington to commandeer our budget and I think they will work with us because they have the same budget problems we do," Negron said.
Reach Gray Rohrer at grohrer@sunshinestatenews.com or at (850) 727-0859.
