The LeRoy Collins Institute expects a coming increase in Medicaid enrollment and calls it the “800 pound gorilla” as we make tough fiscal choices. From the recently updated report “Tough Choices: Shaping Florida’s Future

Medicaid currently accounts for more than 25% of Florida’s budget, insuring a quarter of Florida’s children and funding 63% of the state’s nursing home care. As we noted in Tough Choices: Update 2008, cuts in Medicaid spending not only leave many residents of Florida with costly, uncovered medical expenses but they also leave available matching federal money on the table. Health care research shows that when providers are financially strapped, quality of care for serious conditions gets worse.

In our original Tough Choices recommendations in 2005 we urged a careful assessment of Medicaid as a prerequisite for both making cuts and improving the effectiveness of the massive safety-net program. Instead, the state has continued to cut services here and there without a careful assessment of their impacts and without a full understanding of the intricacies and myriad components of the Medicaid system. We continue to urge a careful assessment of Medicaid, including prioritization of services and recipients, prior to additional incremental reductions.