The first of 11 meetings begins Friday in Tallahassee, with Agency for Health Care Administration officials giving a brief overview of the coming changes to Medicaid before taking questions and comments.
The law moves most of the nearly 3 million Medicaid beneficiaries in Florida from a fee-for-service model of health-care delivery to a managed-care system in which companies vie for contracts in 11 different regions in the state. Even though the law officially becomes effective July 1, the transition into managed care won't begin until 2012.
Lawmakers who pushed the legislation say the changes were borne of the need to reform Medicaid, which was funded at $22 billion this year -- more than half by federal funds with the rest paid for by the state -- and took up nearly 30 percent of the state budget. That number is a stark increase from 11 years ago, when Medicaid ate up 18 percent of the budget.
Republicans vowed to reform the program this year and stop hemmoraging cash on the program and stem the tide by not "kicking the can down the road" as Senate President Mike Haridopolos repeatedly stated.
Some groups are already gearing up to voice their concerns about the law. Local mom-and-pop pharmacies are worried cost-cutting provisions in the law will encourage health-care providers to seek out chain pharmacies in order to meet savings goals, and prevent recipients from getting their drugs at a local store.
"Medicaid patients, particularly seniors and the disabled rely on the in-person assistance provided by local pharmacists. Without open choice and access, many of our most vulnerable citizens may be forced to travel great distances, in addition to ending longstanding and trusted relationships developed with local pharmacists," said Tracy Jackson, owner of a small pharmacy in Monticello.
Jackson is a member of Pharmacy Choice and Access Now, a national organization that is encouraging Florida's small-pharmacy owners to attend the meetings. Republican lawmakers who pushed for Medicaid reforms said the law isn't perfect and could receive tweaks before the transition to managed care begins, but whether greater access to local pharmacies is in the cards remains to be seen.
Meanwhile, the vastly outnumbered Democrats in the Florida Legislature, who fought against Medicaid reforms, are hoping the major reforms contained in the law won't actually take effect, even though Gov. Rick Scott signed the bill into law last month. Because the law changes a federal program that the state administers, a federal waiver is required before the reforms can be implemented. The statewide tour of public meetings is designed to help state officials craft a waiver request, due into the feds by Aug. 1, but Democrats are hoping it will be denied.
"Personally, I would hope that the federal government basically says, 'Sorry, the plan's not going to work, you need to go back to the drawing board,'" said Rep. Mark Pafford, D-West Palm Beach.
While recognizing the need for cost reductions, Pafford said Republicans focused on savings at the exclusion of quality and access to care considerations in their push for reforms. He said the GOP should stop fighting the Affordable Care Act, the federal health care overhaul pushed by President Barack Obama, if they want to save money on Medicaid, even though the law effectively increases the number of people eligible for the program. Florida, backed by 25 other states, is leading a lawsuit claiming the law is unconstitutional.
"No, not necessarily," Pafford said when asked if the federal health-care law would increase Medicaid costs by having more people on the rolls. "You're spreading the risk among more people -- on prescriptions, you're purchasing the drugs in larger quantities," he added.
For his part, Sen. Joe Negron, R-Stuart, who sponsored the Medicaid reform package, repeatedly stated that quality of care was of paramount importance in developing the legislation, with cost reductions a secondary consideration. The reforms are thought to generate $1.3 billion in savings in the first few years, with additional savings in subsequent years.
Here is the schedule of meetings across the state:
Region 1: Monday, June 13 -- 1 p.m.-4 p.m. (CT) Location: City Hall, Hagler/Mason Auditorium, 2nd Floor, 222 W. Main St., Pensacola, 32502.
Region 2: Friday, June 10 -- 1 p.m.-4 p.m. Location: Agency for Health Care Administration, Building 3, Conference Room A, 2727 Mahan Dr., Tallahassee, 32308.
Region 3: Tuesday, June 14 -- 2:30 p.m.-5:30 p.m. Location: Alachua Regional Service Center, 14107 U.S. Hwy. 441, Conference Room 190-A, Alachua, 32615.
Region 4: Tuesday, June 14 -- 9 a.m.-Noon. Location: Department of Children and Families, Main Auditorium, 5920 Arlington Expressway, Jacksonville, 32211.
Region 5: Wednesday, June 15 -- 9 a.m.-Noon. Location: Mary Grizzle Bldg., Rooms 136 and 137, 11351 Ulmerton Rd., Largo, 33778-1629.
Region 6: Thursday, June 16 -- 9 a.m.-Noon. Location: Florida Department of Transportation, Auditorium, 11201 N. McKinley Dr., Tampa, 33612.
Region 7: Thursday, June 16 -- 2 p.m.-5 p.m. Location: Medicaid Program Office, 400 West Robinson St., Hurston Building, Conference Rooms A and D, 1st Floor, Orlando, 32801.
Region 8: Friday, June 17 -- 2 p.m.-5 p.m. Location: Joseph DAlessandro Bldg., 2295 Victoria Ave., Room 165, Fort Myers, 33901.
Region 9: Tuesday June 14 -- 9 a.m.-Noon. Location: Hilton Palm Beach Airport, 150 Australian Ave., West Palm Beach, 33406.
Region 10: Thursday, June 16 -- 9 a.m.-Noon. Location: Marriott Fort Lauderdale North, 6650 North Andrews Ave., Fort Lauderdale, 33309.
Region 11: Thursday, June 16 -- 2 p.m.-5 p.m. Location: El Palacio, 21485 N.W. 27th Ave., Miami Gardens, 33056.
Reach Gray Rohrer at grohrer@sunshinestatenews.com or at (850) 727-0859.
