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The unkindest cut

Gov. Jeb Bush substitutes his own judgment for that of the Legislature in vetoing $91-million to pay increased Medicaid costs for poor elderly people.

By Times editorial
Published May 30, 2006

Gov. Jeb Bush has taken on friend and foe alike in $2-billion worth of vetoes over the past eight years. He says he hunts down legislators' pet projects, particularly those that don't serve a statewide purpose or are not vetted by a government agency, and strips them from the budget on principle. By what standard, then, does he veto old people in nursing homes?

The largest single cut Bush made Thursday in his final and record-total $449-million in vetoes was $91-million to pay increased Medicaid costs for poor elderly people. Don't look for that item in the annual Florida TaxWatch "Budget Turkeys" List. "It should be noted," the group wrote, "that the governor's vetoes today include appropriations in substantive bills that were not included in our review as well as policy choices which don't fall under the TaxWatch turkey purview."

In other words, Bush was playing gotcha with more than just some sneaky politicians.

The Medicaid money was intended by lawmakers to fulfill a promise that has been five years in the making. In 2001, lawmakers demanded that nursing homes improve their care and increase the number of nurses on staff. Last year, lawmakers reneged on that commitment. But this year, they decided to push forward, recognizing that more staff would translate into higher costs for Medicaid to reimburse.

The governor, in vetoing the extra money, noted that nursing homes would still get 6 percent more from Medicaid. "I think," he said blithely, "nursing homes can survive."

Whether nursing homes can survive or not, the governor should not be so eager in this case to substitute his judgment for that of the Legislature. When he vetoes nursing home expenses, he is also undermining a law designed to improve care.

Bush took similar liberties with indigent medical care and emergency trauma centers, vetoing $20-million for Miami's Jackson Memorial Hospital and $500,000 for a Tallahassee Memorial Hospital trauma center. Is serving the medically indigent and critically ill merely a local responsibility?

The governor has correctly chided lawmakers over the years for approving budget items without discussing the ramifications. But his vetoes of nursing homes and trauma centers subject him to the same criticism. How does he justify cutting money for programs that were fully debated and prescribed under law? Nursing home patients are not budget turkeys.

[Last modified May 30, 2006, 06:03:37]