Miami Herald | EDITORIAL

The unkindest cut


OUR OPINION: Fix Medicaid funding formula that would devastate Jackson, Broward hospitals

Among the most urgent tasks facing South Florida’s legislative delegation in Tallahassee is fixing an ill-considered law that diverts millions of federal dollars destined for Miami-Dade hospitals and sends them elsewhere in the state.

South Florida is used to being shortchanged when it comes to state funding. Remember the DCD, the school-funding formula that was changed to deny Miami-Dade cost-of-living dollars when allocating money for public schools? This is the same thing — the total loss for Miami-Dade County is $218 million — yet worse.

The DCD involved a state formula for the state’s own public school money. Lawmakers changed the criteria and — presto! — the money went elsewhere.

In this instance, however, it’s not the state’s own funding, but rather federal money that South Florida has earned by putting local public dollars into healthcare providers like Jackson Health System, Broward Health and Memorial Healthcare System. The federal government rewards communities willing to make a financial sacrifice to strengthen the safety net by providing matching grants on Medicaid funding.

But first, the money goes through Tallahassee, where it gets diverted elsewhere, even to counties — there are 25 across the state — that offer no public money to help their hospital systems. South Florida has been a net exporter of these funds for years, but the change in a 2011 law — funny how it was inserted into the bill without anyone taking much notice — would take even more money out of South Florida.

These provisions go into effect in July. Hardest hit are hospitals that serve large numbers of uninsured and Medicaid patients, and counties like Miami-Dade that put local tax money (the half-penny sales tax) into the pot.

The new approach would affect several hospitals in Miami-Dade County that draw money from what is known as the Low Income Pool. The UM Hospital division, which includes the Bascom Palmer Eye Institute and several clinics, would see its funding drop by $26.6 million. Miami Children’s Hospital loses $12.8 million. Even Baptist Health South Florida, a private nonprofit, would see cuts of $16.3 million.

These cuts would hurt their ability to help Medicaid patients. But they would simply devastate Jackson Memorial Hospital, which would take a $140-million hit.

This is truly the unkindest cut of all. Jackson CEO Carlos Migoya and his team have rescued a public hospital that was drowning in red ink. They don’t want to go under again, but these new cuts will drag the hospital down. Mr. Migoya rightly calls the impending reductions “catastrophic.”

Neither the Jackson CEO nor the heads of public hospitals in Broward oppose sharing funds with others, even with counties where taxpayers have refused to support healthcare providers. But this new funding formula is an abuse. Counties that don’t contribute public money will benefit, and so will private, for-profit hospitals.

And, to make matters worse, there will be no transparency — they don’t have to show that they’re helping the indigent. In fact, they don’t even have to apply for the funds. The money just comes their way.

If the new formula goes into effect, voters in the affected counties may well ask why they bothered to tax themselves when the federal match goes elsewhere.

Local lawmakers have a strong case to make this session. The redirection of funds must be prevented before the bottom drops out of our safety net.

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