The House Health and Human Services Committee met Tuesday to host a forum on Medicaid reform -- this one specifically for public comment -- setting the stage for what will be one of the leading issues when the Legislature convenes in March.
Noting there were many speakers, the chairman of the committee, Rep. Rob Schenck, R-Spring Hill, limited presentations to three minutes each and restricted members to one minute each.
Were here to hear from any and all stakeholders in the process, said Schenck.
Floridas current Medicaid system is broken, unable to guarantee access or quality of care and is unsustainable. The Medicaid system currently eats up one-third of our states annual budget and its costs continue to rise, insisted Schenck. In order to reduce costs and increase the quality of care, we need to gather input and leadership from a wide variety of stakeholders,including doctors, nurses, employees and employers, as well as patients.This first meeting was the first step to reform and I look forward to further discussion and debate.
The goal of this committee is to ensure the delivery of quality health care in a coordinated and more efficient manner, which in turn will lead to greatly reduced costs, added Schenck.
With Medicaid increasingly consuming more of the budget each year, the House leadership is looking to push legislative proposals that send more recipients into managed care by expanding the current pilot program. While there are more than 2.7 million Floridians currently in the program, that population -- and the costs -- are expected to rise.
In the 1999/2000 fiscal year, Medicaid costs came to $7.42 billion, almost 18 percent of the state budget. By the 2009/2010 fiscal year, the costs totaled $18.81 billion, more than 28 percent of the budget. Estimates hold that by the 2014/2015 fiscal year, Medicaid will cost $28 billion, more than 33 percent of the states budget.
Legislators continue to maintain that the system is too complex and inconsistent with too many exceptions. They maintain that the proposed reforms will improve the programs quality by focusing on the patients and by increasing accountability and transparency.
Medicaid reform was introduced last year, but the measure went nowhere. The proposed legislation from last year, which was led by Rep. Dean Cannon, R-Winter Park, who is now the House speaker, looked to establish a statewide managed-care program, dividing the state into six regions. In each region, Medicaid participants would be able to choose from up to 10 different plans. While the bills from last year stalled, the House leadership is planning to make changes to the measures and the committee meeting Tuesday was set up to listen to the public on what changes needed to be made to pass similar legislation in the upcoming session.
The committee listened to almost 20 brief presentations from stakeholders, including nursing home providers, medical companies, hospital groups and advocates for the disabled, children and seniors. The legislators generally focused on listening, with few of them asking questions of the presenters.
The presenters generally expressed support for the reform measure though there were some suggestions on how to change the proposal from last year.
I would encourage you to go forward in your Medicaid debate, said Jack McRay of AARP who called for a bottom up approach to reform. We believe diversity brings innovation and we urge you to follow that line.
Members of the business community expressed their support for the Medicaid reform package.
AIF supported the House proposal last session and we look forward to working with you, Jose Gonzalez of the Associated Industries of Florida (AIF) told the committee.
Florida Health Care agrees that Medicaid is a program in need of reform, said Joe Mitchell of the Florida Health Care Association. We have serious reservations about managed care, added Mitchell, who said the Medicare rate should be passed through and was for eliminating the duplication of regulations.
Ralph Glatfelter of the Florida Hospital Association took aim at the proposed regions from last years bill, saying they were too large and called for creating 20 to 30 medical referral areas instead. We want to work with you in trying to find another approach that is more consistent with what is happening now in medical practice, said Glatfelter.
We will definitely be revisiting that issue, insisted Schenck, who told Glatfelter that population areas needed to be considered in creating regional groups.
Schenck put the committee on notice that they will be tackling the issue in-depth over the coming months.
I hope you guys got a good taste of how complex this issue is and how many moving parts there are, said Schenck. This is only the beginning.
The committee will meet again Thursday to hold a workshop on how the new federal health-care law backed by President Barack Obama will impact the insurance plans of state employees.
Reach Kevin Derby at kderby@sunshinestatenews.com or at (850) 727-0859.
