After Friday, legislative negotiations over unresolved budget items will be decided by the House and Senate budget chairs as opposed to conference committees. (Getty Images)
House and Senate budget negotiators swapped multiple offers Thursday as they rushed to resolve differences in the roughly $115 billion spending plan they are working on.
Legislators have been at it for three straight days tackling items ranging from affordable housing, money for schools and health care, Everglades restoration, and more.
The budget special session — which is scheduled to run until May 29 — will become less frenzied and more secretive in the coming days. That’s because after Friday, negotiations over unresolved items will be decided by the House and Senate budget chairs as opposed to conference committees.
There’s an agreement to spend $19.2 billion in general revenue (GR) for programs that provide health care to the poor, elderly, and disabled as well as people in foster care programs.
And House and Senate health care budget conferees — chosen to negotiate health care spending differences — were busy at work Thursday, meeting twice.
The chambers have agreed to increase nursing homes reimbursements and reduce how much to pay contracted managed care companies for caring for the poor elderly and disabled.
Medicaid reimbursements for hospitals, meanwhile, remain in limbo with the Senate pushing for reductions in payments for inpatient stays as well as outpatient care.
The sides haven’t exchanged offers on anything besides funding statewide programs and special projects. Offers to come together on more detailed budget nuances and changing statutes haven’t emerged.
For the first time since the inception of the mandatory Medicaid managed care program more than a decade ago, the Legislature will reduce reimbursement rates for contracted health plans.
The chambers have agreed to a 1.3%, or $206 million, recurring reduction.
Pensacola Republican Rep. Alex Andrade, chair of the House Health Care Budget Subcommittee, said the DeSantis administration believes the new Medicaid managed care contracts resulted in a 1% savings to taxpayers but that the governor didn’t include those savings in his legislative budget request.
So, Andrade said, the House built in the 1% savings and slightly inflated it.
Meanwhile, the Senate continues to push rate reductions for inpatient and outpatient hospital stays, recommending slashing rates by $37 million and $52.5 million, respectively. The House has not agreed to the reductions.
Keep an eye on APD
House Speaker Daniel Perez, whose brother has autism, has been candid about his interest in the Agency for Persons with Disabilities (APD) and the care the state helps provide for people with disabilities.
To that, the House has increased funding for an APD “maintenance and repair trust fund” from $3 million in the initial House budget to $19.3 million in the latest House offer. The Senate, which initially had no funding for the account, offered earlier Thursday to spend $18 million on the fund.
The $19.3 million appropriation matches the amount that the House has included in a second APD trust fund for capital improvement projects. The Senate has put just $633,000 into the second fund.
While the amount the House wants to spend in the trust funds grows, the chamber has pared back from $23 million to $11 million the amount of money intended to eliminate a lengthy waitlist for a waiver program called the iBudget.
The Medicaid waiver program provides home- and community-based services to people with intellectual and developmental disabilities. The Senate hasn’t directed any money toward eliminating the waitlist.
And after not requesting any increases for iBudget support coordinators, the House on Thursday night requested $22.7 million in funding. The Senate’s budget provides $10 million for increases for the people who help iBudget clients get the services they require to stay living in the community instead of institutions.
