Miami-Dade gets fewer coronavirus relief dollars despite higher COVID infection rates
Miami-Dade County received a smaller share of federal healthcare funds to fight coronavirus than other major metro areas in the state despite having a higher rate of COVID-19 infections and deaths, according to data compiled by the Miami Herald.
Miami-Dade’s share of $30 billion in healthcare funds, part of the $2 trillion coronavirus relief bill passed by Congress in March, was distributed based on the county’s share of Medicare fee-for-service reimbursements. But that funding formula, from the Department of Health and Human Services, meant less money for areas like Miami-Dade, where a higher portion of the population relies on a private-plan version of Medicare called Medicare Advantage.
Jackson Health System CEO Carlos Migoya sent a critical letter to HHS Secretary Alex Azar last month, saying the funding method could jeopardize “the very existence” of health systems like Jackson, which has already grappled with the possibility of pay cuts and furloughs in the midst of the pandemic. Democratic and Republican lawmakers from Miami-Dade County also criticized the funding method. Jackson received $24 million.
“I have talked to Secretary Alex Azar myself and I know he understands the point that we’re being discriminated against,” said Miami Democratic Rep. Donna Shalala, who was the HHS secretary during the Clinton administration. “If you look at Naples, they use Medicare fee-for-service more than we do and they got more money.”
Republican Rep. Francis Rooney’s district, which includes Naples and Fort Myers, received $130 million and is home to three hospitals with more than 400 beds. Shalala’s district, which includes areas of Miami-Dade County near the coast, received $66.7 million despite being home to four hospitals with more than 400 beds.
Miami-Dade County had 432 of the state’s 1,539 coronavirus deaths as of Thursday afternoon, and the county’s number of deaths per 100,000 people, 15.9, is the highest death rate among large counties in Florida. Miami-Dade County has 13,371 confirmed COVID-19 cases, the highest total in the state, and the highest rate of cases per 100,000 people among large counties. Gov. Ron DeSantis did not include Miami-Dade, Broward and Palm Beach Counties in his initial reopening plans because of the higher infection rates there.
Shalala’s district was the only Miami-area congressional district that received an above-average share of federal dollars, ranking 202nd out of 435 seats nationally. Democratic Rep. Frederica Wilson’s district, which includes Jackson Memorial, the largest hospital in South Florida and Miami-Dade’s public hospital, ranked 289th. Democratic Rep. Debbie Wasserman Schultz’s district, which is based in Broward County but includes portions of Miami-Dade, ranked 345th. Republican Rep. Mario Diaz-Balart’s district ranked 376th while Democratic Rep. Debbie Mucarsel-Powell’s district ranked 421st, the lowest ranking of any Florida congressional district.
“One of the things we were asking for is for funds to not be based on Medicare but instead use patients treated for COVID,” Mucarsel-Powell said. Mucarsel-Powell is also introducing legislation that would make COVID-19 treatments free for Medicare Advantage recipients.
Other Florida seats fared much better.
Tampa Democratic Rep. Kathy Castor’s district ranked 3rd in the country, receiving $197.7 million. Four other Florida districts ranked among the top 20 in the country, including Rooney’s, Republican Rep. Brian Mast’s Treasure Coast district, Republican Rep. Vern Buchanan’s Sarasota-based district and Democratic Rep. Ted Deutch’s district, which includes portions of Broward and Palm Beach counties.
Miami’s Jackson Health System, which includes Jackson Memorial, got nearly $24 million, just under half of the $46.4 million the Orlando Health system got, despite the fact that the systems have a similar number of beds. Miami Dade-County has nine times more positive COVID-19 cases than Orlando’s Orange County.
The Florida Cancer Specialists and Research Institute, based in Fort Myers but with locations across the state, got the most money so far, receiving more than $67 million.
The money is a grant and does not need to be repaid.
Shalala said Miami fared slightly better during a smaller, second round of funding from HHS that included $12 billion for coronavirus hot spots and $10 billion for rural areas. Shalala said children’s hospitals like Miami Children’s Hospital, which received nothing in the first round because none of its patients use Medicare, received relief in the second round.
But about $100 billion of the $175 billion allocated from Congress for healthcare providers to fight the effects of COVID-19 has yet to be distributed by HHS.
“We have the largest amount of COVID and huge hospital systems that are really at risk, and we have deep penetration into Medicare Advantage,” Shalala said, of Miami-Dade County. “They still have $100 billion they haven’t distributed. There’s no reason to hold back that money.”
Because infection rates have remained low enough for most hospitals to meet patient demands, Shalala said the federal money is mostly being used to keep hospitals open that have seen revenue dry up in recent months after canceling elective procedures due to the pandemic. She also said the federal government must be proactive and allocate funds to prevent future outbreaks, rather than responding once an area is already hard-hit.
“We’re losing hundreds of millions of dollars because we’re not doing our regular surgeries or cancer treatments,” Shalala said. “We put it off and we can’t put it off too long. The revenue gap is huge and there’s still a gap in getting [personal protective equipment] in our communities, not just for hospitals but for everybody.”
This story was originally published May 7, 2020 at 4:35 PM.
