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TALLAHASSEE - Gov. Jeb Bush's proposal to eliminate a $400-million health care program for the poor got a skeptical reception from legislative leaders on Wednesday.
"To totally cut it out is probably draconian," said House Speaker Allan Bense, R-Panama City.
"I would be surprised, and I think it would be unfortunate, if (the Medically Needy program) isn't funded," said Senate President Tom Lee, R-Brandon.
Bense's opposition could be particularly troubling for Bush because the House has been more willing to consider cutting the program in the past, while the Senate fought to save it.
As part of his budget plan, Bush on Tuesday proposed eliminating Medically Needy, an optional Medicaid program that covers 30,000 poor, uninsured Floridians with catastrophic illnesses and injuries.
The program has been on the chopping block each year for at least four years, but each time lawmakers saved it when confronted with the life-and-death consequences of ending it.
Lee offered a pragmatic reason for keeping the program. "When you push people out of these programs, they present (themselves) somewhere else, often the emergency room, which is the most expensive, or worse, perhaps the funeral home," Lee said.
Some might wind up in other government-funded programs, such as Hillsborough County's indigent health care system, which Lee said merely shifts responsibility to local taxpayers.
Bush's budget is merely a recommendation. The Republican-controlled Legislature will have its own ideas. The two sides must agree on a budget by July 1.
Bush's proposed cut came a week after he proposed turning Medicaid over to private health insurers. The federal-state program consumes a quarter of the state budget and is still growing.
Some health care advocates question whether Bush is proposing to eliminate Medically Needy as a way to demonstrate what's at stake if the Legislature does not approve his Medicaid plan.
Social services lobbyist Karen Woodall said she worries about the strain on Medically Needy participants. "Those people still have to worry and suffer about it being cut," she said.
Lee and Bense praised Bush for tackling Medicaid, saying something must be done. Medicaid spending has doubled the past six years. To maintain current services for all 2.3-million beneficiaries, and to keep up with growth and inflation, the costs would grow to $17-billion next year. Bush proposed spending $14.7-billion.
On Wednesday, Lee appointed a special Senate committee to consider the Medicaid proposal and take testimony from those who would be affected by changes, patients and providers alike. But putting all the pieces in place, plus getting the approval of state lawmakers and federal regulators, will take at least a year.
Meanwhile, the state ought not sever the Medically Needy lifeline that keeps severely ill people alive until it has another way to serve them, said Sen. Walter "Skip" Campbell, D-Fort Lauderdale.
Campbell said he doesn't think that will happen.
"I think the political pressure will be there to keep it," he said.