The Florida House advanced two Medicaid reform bills Tuesday -- HB 7107 and HB 7109 -- setting the stage for a debate and vote later in the week on one of the most pressing issues impacting the Sunshine State.
With a host of worthies -- including Gov. Paul LePage, R-Maine, and Bishop McKinley Young of the AME
Church -- watching the proceedings, Rep. Rob Schenck, R-Spring Hill, the sponsor of the measures, took often-pointed questions from Democrats for the better part of two hours.
The measures -- which ranked as one of the House leaderships top priorities for the 2011 session -- send most Medicaid recipients in the state into managed-care plans, including HMOs. House Republicans, who have been looking to push the measure over the last year, pointed to the growing number of recipients and warned that these numbers would only increase if nothing is done. The measures also include a liability provision -- limiting potential damages to $300,000; a reduction of $200,000 from the current system -- when medical personnel are found liable for injuries to patients on Medicaid.
Supporters of the measures point toward the increasing costs and the increased number of Medicaid recipients in Florida.
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.
There are 2.9 million enrolled recipients today, said Schenck, who chairs the House Health and Human Services Committee. In his remarks opening the questioning session, Schenck estimated that Medicaid cost the state $20 billion and the costs would rise. We are going to improve the quality of care that our Medicaid recipients get, said Schenck, adding that the measures would also help control costs.
House Democrats, who opposed the reform measures at every committee stop, tried to tangle Schenck and other Republicans on the merits of the measure.
Rep. Steven Perman, D-Boca Raton, asked Schenck if other states followed a similar model.
We looked at their models and incorporated things they do well in our model, said Schenck, pointing to Texas and Arizona.
There still remain so many areas that have made me very, very uncomfortable, said Rep. Elaine Schwartz, D-Hollywood, who unleashed a series of questions.
Managed care can make money when people dont use their services, insisted Schwartz. How can it be that someone can make a profit without limiting services when your population is not healthy to begin with?
Schwartz also maintained that the House had not been provided with all the information needed to make their decision.
We have received no encounter data, insisted Schwartz. No encounter data have been coming in the last four and a half years.
Schwartz maintained that there was no proof that the reforms were going to save money. Where is the savings? she demanded. There have been no savings shown.
Republicans continued to maintain that the reforms would be patient-centered and save the state money in the long run.
Rep. Matt Hudson, R-Naples, replied that there would be no immediate savings but that the measures would increase access and improve care for more Floridians.
Rep. Jim Waldman, D-Coconut Creek, demanded to know if Solantic, the medical company that Gov. Rick Scott helped set up before his term in office, would be eligible to receive Medicaid funds.
Schenck replied that free-market solutions left HMOs able to contract with whomever they wished.
Democrats attempted to amend the measures. Rep. Janet Cruz, D-Tampa, looked to increase the reform plan from eight districts to 11 -- far below calls in the Senate to establish 19 regions. The amendment failed on a party lines vote. Rep. Mia Jones, D-Jacksonville, also sought to change the reform package, offering three amendments on rate adjustments and medically needy enrollees. An effort by Rep. Mark Pafford, D-West Palm Beach, to eliminate some of the managed-care problems also went down to defeat.
After committee meetings on Wednesday, the House will reconvene for a Thursday afternoon session -- when the Medicaid reform bills will resurface.
Reach Kevin Derby at kderby@sunshinestatenews.com or at (850) 727-0859.
