Florida could become the first state to leave Medicaid, the federal health care program for the poor and elderly, if its attempt to reform the program is rejected by federal authorities, state legislators said Wednesday.
Sen. Joe Negron, R-Stuart, who is co-sponsoring Medicaid reform legislation, said that Florida would go its own way in providing health care for needy citizens if the state doesn't get greater flexibility in running the program.
In the unlikely event that Washington decided, Were not going to work with you, instead were going to dictate unilaterally the terms of surrender, then as a state, were prepared to manage our own program with our own resources and we set out in the bill exactly how were going to do that, Negron said.
Negrons bill, set to be unveiled Thursday, is expected to save $1 billion in state and federal money in the first year and $4.3 billion in the first three years. Medicaid currently eats up nearly 30 percent of the state budget, with $20.3 billion spent on the program for which 2.9 million Floridians are eligible.
Although specifics of the bill wont be released until Thursday, it will cut optional services of the Medicaid program, give recipients greater control over their health care and promote preventative care and greater individual responsibility in order to decrease the amount of costly care services.
Our goal is that the Medicaid benefit would be roughly comparable to the private-sector benefit, Negron said.
Its unclear how amenable federal authorities will be to Floridas request for greater flexibility in operating its Medicaid program. The Sunshine State has been refused a waiver to expand a pilot program in Broward, Duval, Nassau, Baker and Clay counties that places recipients into managed-care programs run by private companies, unless it makes changes to the program.
But Negron says hes been hearing positive signs from Health and Human Services Secretary Kathleen Sebelius and White House staffers that President Barack Obamas administration may be open to giving states greater autonomy in running their Medicaid programs.
Im encouraged by comments Ive read from the White House from individuals Ive talked to who worked at a staff level at the White House that the administration is very open to innovations from the state houses, Negron said.
According to Sen. Don Gaetz, R-Niceville, the new tone of flexibility on Medicaid coming from the Obama administration stems from the Republican wave election in 2010 and the rejection by the public of his federal health care law.
The Obama administration a year ago was much more arrogant and much more dictatorial about health care policy than they are today. The president and his administration I think received a pretty resounding message that federal health policy ought to be developed in a collegial fashion, Gaetz said.
Florida has also played a large role in fighting Obamas Affordable Care Act, leading a group of 26 states in a lawsuit against the law, which U.S. District Court Judge Roger Vinson recently ruled was unconstitutional.
The ruling is currently being appealed, but if the health care law is upheld, it would expand the number of Medicaid recipients in Florida by 2 million new enrollees. Gov. Rick Scott has stated that state agencies will not be preparing for the expansion of Medicaid ahead of the effective date of that provision in 2014.
Gaetz, while decrying the Affordable Care Act and supporting efforts to overturn it, said the Medicaid reform legislation assumes the law will be upheld.
The bill presupposes that the federal laws that are on the books now will remain on the books. But obviously our hope here in the Florida Senate is that what has been commonly called Obamacare is going to be overturned, Gaetz said.
The Senate Subcommittee on Health and Human Services Appropriations, which Negron chairs, will discuss the bill in their meeting Thursday.
Reach Gray Rohrer at grohrer@sunshinestatenews.com or at (850) 727-0859.
