House Republicans on Tuesday released a proposed health-care budget and an accompanying bill that could lead to putting people with disabilities in managed-care plans. 

The proposed budget for the upcoming fiscal year also would make permanent a $103 million reduction to the state’s Medicaid program and reduce Medicaid spending at Florida’s hospitals by about $111 million in federal and state funds. Those reductions would come in reimbursements for inpatient and outpatient care.

The House Health Care Appropriations Subcommittee did not receive any public testimony about Chairwoman MaryLynn Magar’s proposed budget.

But the accompanying bill, which would make necessary statutory changes to carry out the budget, passed by just a one-vote margin with all the Democrats on the committee voting against it.

Republicans voted in a bloc to advance the measure. Several lawmakers were absent when the vote was taken, presenting bills in other committees.

Debate on the bill also was limited, with only Rep. Loranne Ausley, D-Tallahassee, speaking against it.

“Generally, I think there are some provisions in here I have concerns with,” she said, noting that she didn’t think the state should make permanent a decision to eliminate a 90-day period people have to fill out Medicaid paperwork and qualify for coverage.

The Legislature last year agreed to eliminate the longstanding 90-day policy and  — for one year — to require people to fill out Medicaid paperwork the same month they qualify for the  program. The Legislature exempted pregnant women and children from the change, which means it only impacts seniors and people with disabilities.

The House has recommended making the cut permanent by including it in the bill that would accompany the new budget. While the Senate won’t release its proposed health-care spending plan until Wednesday, senators are moving forward with a separate bill that would make the $103 million cut permanent.

Karen Woodall, executive director of the Florida Center for Fiscal and Economic Policy, is lobbying lawmakers to move ahead with the cut, but to include it in the budget, so it would only be in effect for the coming year — and not be permanent. The budget is an annual document.

Woodall said lawmakers should examine the impact that the change has on elderly and disabled residents before moving to make it permanent. The federal government, which approved the change for the current year, directed the state to examine what impact it would have.

The House also would require the state Agency for Persons with Disabilities to remodel its existing Medicaid “waiver” program for people with disabilities if it runs a deficit at the end of June.

Ausley said it is “pretty clear” that there is a deficit and that the best thing for the state to do would be to better fund the program, which uses a system known as iBudget. The program serves about 34,000 people with intellectual and developmental disabilities. There are about 21,000 more on the waiting list for the program.

It is one of the few Medicaid programs that runs independently from a statewide Medicaid managed-care program. As of February, Florida had about 3.8 million Medicaid beneficiaries, with nearly 3 million of them enrolled in managed care.

“Rather than putting them through corrective action, the most critical thing we could do is to provide them with more resources to serve their population,” Ausley said regarding the APD proposal.

Overall, Magar, R-Tequesta, released a budget that proposes spending nearly $37.2 billion in five state agencies related to health and human services. The Agency for Health Care Administration, which runs the Medicaid program, accounts for the majority of the spending, with $29 billion.

The full House and Senate in the coming weeks will approve overall budgets and then enter negotiations on a final spending plan for the 2019-2020 fiscal year, which starts July 1. The House proposal on Tuesday is an early iteration of the spending plan.

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