Florida lawmakers weigh Medicaid overhaul

Health News Florida: "In a surprising turnaround from last week, a top Senate health chairman Monday called off two meetings that had been scheduled to scrutinize a House proposal for overhauling the Medicaid system. The Senate Health Regulation Committee planned to hold more than nine hours of meetings Wednesday and Thursday to study House bills that would require almost all Medicaid recipients to move into managed-care plans. But committee Chairman Don Gaetz, R-Niceville, sent a short memo to other senators late Monday afternoon saying that the meetings would not be held." The state Senate has already passed a bill that would "shift Medicaid recipients into managed-care plans" but it is different than the House version. "Ultimately, any Medicaid changes would need agreement between the House and Senate. That could spark heavy negotiations before the April 30 end of the legislative session" (Saunders, 4/12).

The Gainesville Sun: The House proposal "would establish the Florida Medicaid program as a statewide integrated medical care program for all covered services, including long-term care, over a five-year period. Under the plan, Florida would be divided into six regions and each area would have a minimum of three to five plans and maximum of 10 plans to choose from. ... With the health-care bill approved in Washington, Florida's Medicaid enrollment will swell by more than a million new participants. ... Officials said Florida spent $18.81 billion for fiscal year 2009-2010, or 28.3 percent of the total state budget. If the growth rate continues at the same level, by fiscal year 2014-15, the expenditures are estimated to be $28 billion, or 33.4 percent of the state budget" (Word, 4/13). 

The Associated Press/Bloomberg BusinessWeek: The House plan would be an expansion of a five-county pilot program. "Lawmakers see the plan as a way to rein in the growing cost of the fraud-plagued state-federal program that provides health care for 2.7 million low-income and disabled Floridians. The program is expected to consume $19 billion in the next fiscal year and account for more than a quarter of the state budget. ... House Speaker-designate Dean Cannon, R-Winter Park, said there's enough anecdotal and preliminary evidence that managed care cuts costs and fraud while still providing quality care to go ahead with the plan. However, data from the existing experiment has yet to be fully analyzed. ... There was plenty of discomfort about the bills that are on a fast track after getting a late start. House leaders waited until last week to unveil the plan, and now just 18 days remain in the 60-day session" (Kaczor, 4/12).

The Ledger: The House  "bill now heads to the House floor, although it remains a far more ambitious program than a Senate plan to increase managed care in less than a third of Florida's counties. ... The House plan differs from a Senate measure to expand the existing Medicaid pilot programs in Broward County and the Jacksonville area to 19 additional counties, including Polk County" (Dunkelberger, 4/12).

The Palm Beach Post: "But representatives of groups that provide developmentally disabled services, home-health care equipment, and advocate for nursing home residents were among those urging that lawmakers study the plan for another year before acting -- perhaps opening the historic rewrite to more public review. ... Rep. Gary Aubuchon, R-Cape Coral, shrugged off calls for delay, pointing out the plan already provides a five-year phase-in, with long-term care for the elderly and services for those with developmental problems the last to take effect."

"Miami-Dade has been targeted for reform by lawmakers since it's seen as the nation's epicenter for Medicaid fraud. Home health care agencies in the county, for example, draw close to half of the almost $200 million Florida spends on claims for these services — despite the county only containing about 20 percent of the state's Medicaid population. With 80,000 Medicaid service providers statewide, Florida officials acknowledge their system is likely pocked with fraud and waste. But HMOs and PSNs are expected to have a profit motive to weed out waste" (Kennedy, 4/12).

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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.