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Florida's post-storm income rise cuts federal Medicaid cash

BY LESLEY CLARK, Miami Herald

''This is a significant loss of revenue that could affect the disabled, nursing home residents, mothers and children,'' said Rep. Kathy Castor, D-Tampa, who is leading efforts within the delegation to find a fix.
Florida's record spate of hurricanes was great for blue tarp manufacturers and apparently, the state's per capita income, which surged in a post-storm construction boom.

But those years are over and the boom now is taking a bite out of the state's share of federal Medicaid dollars. Because the federal money is doled out according to a formula based on the state's past per capita income, its share of federal dollars is dropping, even as demand for Medicaid increases and the state's fiscal picture dims.

''Those were the boom years for a bunch of states and now, when they need it, the states are feeling the pinch,'' said Matt Salo, director of health and human services for the National Governors Association, who joined state officials Wednesday to plead with Florida's congressional delegation to address what the state estimates could be a $500 million hit.

''This is a significant loss of revenue that could affect the disabled, nursing home residents, mothers and children,'' said Rep. Kathy Castor, D-Tampa, who is leading efforts within the delegation to find a fix.

Castor said House leadership has shown interest in addressing the issue in upcoming legislation. In 2005, she noted, Congress increased the Medicaid payment for states affected by Hurricane Katrina.

''Seven hurricanes in two years [Charley, Frances, Ivan and Jeanne in 2004 and Katrina, Rita and Wilma in 2005] and subsequent reconstruction activity are skewing the Florida [Medicaid] formula,'' Castor wrote in a letter to House Speaker Nancy Pelosi. ``This anomaly has resulted in significant projected reductions in health services to Florida's neediest residents.''

The portion of Medicaid paid by the federal government is calculated on a three-year average of state per capita personal income, compared with the national per capita income.

For the fiscal year that began in October, Florida's federal share dropped nearly two percentage points, from 59 percent federal match to 57 percent. And it will drop again in the federal budget that starts in October, from 57 percent to 55 percent, said Carlton Snipes, acting deputy secretary for Medicaid at the Florida Agency for Health Care Administration.