The Senate budget would cut the Medically Needy program, which aids extremely ill Floridians who can't get health insurance.
By ALISA ULFERTS
Published April 11, 2004
TALLAHASSEE - Tiffany Reid needs a new set of lungs.
A state health care program pays for the medicines that keep Reid, a 32-year-old Bradenton mom with cystic fibrosis, alive until a donor can be found. Reid also needs the program to pay for her operation when she gets the call she's waited more than a year to hear.
But the Florida Senate wants to gut the Medically Needy program, which serves extremely ill Floridians who can't get health insurance, and replace it with a prescription-only plan.
If that happens, Reid will be taken off the transplant list because she can't afford the operation herself, even with other federal assistance she gets. Without new lungs, Reid likely will die within two years.
There is an out: If Reid's husband leaves her and their three children, she would qualify for Medicaid, the state/federal health care program for the poor, which would pay for the operation. The Reids already divorced in anticipation of the cut, and are waiting to see if he'll have to move out completely.
"If I don't have a husband I can get my lungs," she said, "If I have a husband I don't get my lungs."
Reid is one of thousands of Floridians playing what has become an annual game of cat and mouse with the Legislature - waiting to see whether the health care programs that keep them alive or well will survive another tough budget year.
Last year, lawmakers cut Medically Needy but changed their minds after hundreds of the 27,000 people on the program beseeched them to save it. The Senate led the fight to restore the program, passing several emergency bills to keep it afloat and pleading with the House to pass one before the program's May 1 midnight expiration last year. The House took up one of the bills and passed it with less than an hour to spare.
But this year it's the Senate that has put Medically Needy back in jeopardy. The Senate's budget also would cut prenatal care for about 7,000 poor pregnant women, as well as transportation to the doctor for Medicaid patients who have no vehicle. Meanwhile, the House would fully fund those programs and add money for others that lawmakers cut last year.
"This budget is fiscally tough where we needed to be but people-kind where we could be," House budget chairman Rep. Bruce Kyle, R-Fort Myers, said when the House approved its budget plan late last month.
Although Gov. Jeb Bush did not propose the Medically Needy cut in his budget, he has endorsed the Senate plan.
There is growing sentiment among senators this year that the state can no longer afford to build its budget on the unreliable sources of money that have helped pay for those programs in recent years. Many of these programs have been partially funded by one-time sources of money such as federal surpluses or extra cash in state trust funds.
Led by incoming Senate president Tom Lee, R-Brandon, and supported by Senate President Jim King, R-Jacksonville, senators say continuing the practice is a risk to the state's financial health. Florida simply cannot afford to pay for every health care program lawmakers would like to provide.
"It would be so easy to listen to the hue and cry of those people," King told senators late last month when they passed their budget. But financing every program possible "really is the road to fiscal oblivion," King said.
That leaves people like Reid waiting and watching, hoping that the threatened cut to Medically Needy is just a bargaining strategy and that the program will be restored this week when the House and Senate hammer out the differences in their two budgets.
Reid has contacted every lawmaker she can think of, even Gov. Jeb Bush.
"I get up, I do my medications and then I type out letters," Reid said.
"I'm pretty much running out of time."
Uncertainty strains family
Florida lawmakers created the Medically Needy program in 1986 to help cover gaps in regular Medicaid. Although it falls under the umbrella of Medicaid, a nearly $14-billion program that has doubled in size in just six years, Medically Needy is an optional program that states can provide but aren't required to under federal Medicaid rules. It covers drugs and hospital care for extremely sick people, such as organ transplant recipients who can't get insurance.
But because the state doesn't have to provide it, Medically Needy becomes one of the first places lawmakers look for savings to trim an out-of-control Medicaid budget.
During last year's scare, Reid and her husband John, a school custodian, divorced so Reid could qualify for Medicaid if a set of matching lungs became available and Medically Needy was no longer available. The move upset the couple's three children, Damon, 10, Zoe, 7 and Nikita, 5.
"We keep telling them it's not that we don't love each other. It's so I can get my medicine," Reid said. (This year the state is spending $1.7-million in federal grant money to strengthen marriage and families.)
But simple divorce isn't enough; John Reid will have to move out of the house completely to drop Reid's household income to the level where Medicaid coverage would kick in. Even though Reid's disability garners her benefits under Medicare, the federal health program for the elderly and disabled, she still would have to come up with at least $20,000 for her lung operation without Medicaid.
If she can't produce that, Reid said, her doctors have told her they have no choice but to drop her.
"Either you show them you have that kind of money saved up or they take you off the transplant list," Reid said. She's growing weary of the strain, and weary of writing letters to lawmakers that go unanswered.
Mostly, Reid said, "I'm getting sick and tired of being sick and tired."
- Times researcher Deirdre Morrow contributed to this report.
