Education or health care?
That’s a choice Florida budget writers face, according to state Rep. Jeff Brandes, a Pinellas County Republican.
Brandes told WUSF’s Florida Matters that growth in Medicaid, the state-run health care program for the poor and disabled, was limiting the state’s ability to spend more on education. Medicaid has grown to 30.7 percent of the budget in the current spending plan from 22.2 percent of the budget in 2008.
That’s an increase of more than one-third in four years.
“How do we fund anything if 50 percent of the budget is Medicaid and education?” Brandes asked, noting the Legislature may have to take from public safety, transportation and other quality of life items.
Brandes’ numbers need some context if lawmakers’ decisions are being cast as health care versus education.
Medicaid costs have grown to 30.7 percent of the total state budget, which includes the federal money that makes up the bulk of state Medicaid spending. The federal government matches every state dollar spent on Medicaid with several federal dollars, which varies by program. That federal money is restricted to health care and could not be spent elsewhere.
Much of the Medicaid growth is due to the federal stimulus and Florida’s 2009 $1-per-pack cigarette tax increase. Florida is also limited by federal law from cutting Medicaid eligibility or services.
For the portion of the budget lawmakers have the most control over, general revenue, Medicaid is growing more slowly. Medicaid grew to 18.5 percent of general revenue this year from 16.8 percent in 2008, a 10.1 percent increase. Education has grown to 35 percent of general revenue from 32.8 percent in 2008, a 6.7 percent increase.
Shrinking general revenue means the state is spending less, overall, on those programs. Florida will spend $448 million less on Medicaid this year than it did in 2008 and $1.12 billion less on education this year than in 2008.
Brandes said lawmakers have an obligation to pay-for-performance they required of school districts this year. Listen to the rest of the Florida Matters discussion on merit pay, charter schools and more here.