Florida faces fight over Medicaid reform expansion; In Kansas, cuts hurt a mental health clinic

Florida's Agency for Health Care Administration may broaden that state's Medicaid-reform pilot program to include 19 more counties to save more than $58 million by requiring Medicaid beneficiaries enroll in managed-care plans, Health News Florida reports. "Such an expansion could affect 375,000 people and save $58.7 million during the upcoming fiscal year. Managed-care supporters say expanding the pilot program would help reduce fraud and hold down spiraling Medicaid costs." The expansion could cover Miami-Dade County. "Advocates for Medicaid enrollees have long been wary of the program, in part because of concerns that managed-care organizations will save money by squeezing care. House and Senate committees have been studying the issue, and Gov. Charlie Crist said last week he was 'open' to expanding the program, after opposing such a move for three years" (Saunders, 2/18).

The Associated Press/The Miami Herald report that Florida's Medicaid program faces other obstacles, including "a class-action Medicaid lawsuit that could cost the state millions, all while waiting to see if a federal health bill will affect the state." In Medicaid, the "state expects to pay $17.9 billion to serve 2.6 million recipients — one out of every seven residents — and an 11 percent increase from last year." Those numbers have led to the effort to extend the pilot program. "Nearly four years into the (pilot) program, there are small reductions in expenditures but it's unclear whether the savings stem from providers offering less care or because they're delivering it more efficiently, according to (a University of Florida) study. Overall, Medicaid recipients' satisfaction levels do not differ dramatically pre and post reform" (Kennedy, 2/18).

In Kansas, Medicaid cuts are hurting a mental health center in Lyon County, The Emporia Gazette reports. "Bill Persinger, executive director of the Mental Health Center, gave a report to commissioners detailing the center's status. … Persinger said the 10 percent cuts in Medicaid handed down at the state level have affected the center greatly. 'About the time we closed all the gaps in care, about the time we had a little money at the end of the day, we got the cut,' Persinger said. The center also took a 50 percent hit in cuts in state grant funding, Persinger added. 'With those grant cuts, our capacity to deliver charity care has been greatly reduced,' he said" (Nance, 2/18).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.