Most of Floridas 2.9 million Medicaid recipients could be moving into managed-care health plans next year if a bill introduced in the state Senate Thursday makes its way into law.
The bill plans to save the state $1 billion in the first year with increased savings over time. Legislators have been keen to pass Medicaid reform legislation this year after failing last year to reduce expenses in a program which currently eats up nearly 30 percent of the state budget.
Sen. Joe Negron, R-Stuart, who has been leading the push for Medicaid reform from his position as chairman of the Health and Human Services Appropriations Subcommittee, unveiled the bill in his committee.
The bill will move Medicaid recipients into health plans run by managed-care companies, with a competitive bidding process overseen by the state Agency for Health Care Administration with provisions guaranteeing savings. The plans will be required to spend 90 percent of their Medicaid funds on health care, keeping administrative costs to a minimum.
Savings will also be found by reducing services for those in Medicaids medically needy program to just physician care. The program currently provides services included in Medicaid to families above the federal poverty line who are hit hard by medical bills. Negrons bill renames the program the Medicaid nonpoverty medical subsidy.
Democratic leader Sen. Nan Rich of Weston took issue with the language change and the reduction in services.
I believe there are some people out there who are in poverty but arent eligible for Medicaid, but are eligible for the medically needy, Rich said.
For Negron, it was simply a matter of being able to pay for services when the state is facing a $3.6 billion deficit.
When we have the resources, I am perfectly happy to pay for people who have medical expenses, Negron said.
In order to get the $1 billion in savings in the first year, however, there will also be cuts in Medicaid payments to physicians.
Some of thats obviously going to have to be achieved through reductions to providers, Negron said.
Since many of the bills provisions require federal approval, the bill also sets out the timeline for Floridas possible withdrawal from the Medicaid program if the state isnt given more flexibility to run it.
If passed by the Legislature and signed by Gov. Rick Scott, the law would take effect July 1. AHCA would send a request for waivers on Aug. 1 to the federal government. If Florida doesnt receive a favorable response by December, Negron says the state would go its own way in providing health-care services to its poorer citizens, making it the first state to leave Medicaid.
That could be problematic, though. Florida currently pays about less than half of the $20 billion cost of Medicaid, with the rest of the tab picked up by the federal government.
Negron is confident that federal authorities will prove flexible in granting Florida greater leeway in running its own Medicaid program, and that any such opt-out wont be necessary.
There isnt going to be an emergency, there isnt going to be a crisis. Im certain that the Obama administration and the federal government isnt going to walk away from 3 million Floridians, Negron said.
Rich wasnt so confident of a favorable response from federal authorities.
Unlike you, I do feel like there would be a crisis in this state if we werent part of the federal governments Medicaid program, she told Negron.
Sen. Steve Oelrich, R-Gainesville, likened Floridas rock-and-a-hard-place budget decisions to a triage situation.
What weve had to do here is take our limited resources and apply them where theyre most needed, Oelrich said.
Reach Gray Rohrer at grohrer@sunshinestatenews.com or at (850) 727-0859.
