The Legislature is currently finalizing budget categories and aligning numbers.

As the rumors go, it seems that there is a move afoot in some internal discussions to possibly pare down hospital funding for the medically needy to reach a spending compromise between the House and the Senate.

The keyword here is “possibly.”

Here’s why that is a bad idea. The federal government funds about 60% of Florida’s $33.4 billion Medicaid program. Every state dollar pulls down about $1.50 in federal funding. If you cut state dollars, Florida forfeits the federal match too.

This should be a concern for all of us. Hospitals, particularly rural hospitals, are required by federal law to serve people in need, regardless of whether they have insurance.

The margins under which rural hospitals operate are already strained. Without full funding for the medically needy, some hospitals may have to either close their doors or severely curtail services for the general population.

This would hurt rural communities and specifically rural seniors in a really damaging way.

Now, for some more thoughts on Medicaid funding.

First, it does not disappear. Anything not used in Florida will simply go to other states, such as California and New York.

Second, Florida’s Medicaid program isn’t bloated. Enrollment has grown only 5.6% since 2020, slower than the state’s population growth of roughly 8%. Each year, each recipient must prove that they qualify.

Third, Florida has kept eligibility narrow by design. It does not help adults. For the most part, it is focused on children and people with disabilities. For instance, in Florida, an adult with dependent children qualifies only if they earn up to 27% of the federal poverty level. That’s less than $5,662 a year for a family of two.

The rolls are mainly filled with kids in low-income households, pregnant women, seniors in nursing homes who outlived their savings, and Floridians with disabilities.

It truly is a safety net focused on the truly vulnerable and built around personal responsibility for everyone else.

Cutting Medicaid would not punish freeloaders because there are very few to punish. It would hurt the grandmother in long-term care, and the toddler who needs a pediatrician, and it squeezes doctors and hospitals, who are already paid below the cost of providing care.

There are many reasons for a broader discussion about reforming our medical system. We need to overturn Obamacare, get the US government out of the dominant “customer” role in our healthcare system, and restore true market forces to ensure both transparency and accountability in healthcare.

But until then, cuts to our hospitals in the name of efficiency in one year can lead to a compounding problem for other years and cause healthcare access to suffer for seniors and children – even for those who do have insurance or can pay.

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Randy Ray serves as Chair of Senior Consumers of America.

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