The House Medicaid reform bills, sending most recipients in Florida to managed-care plans, passed the Committee on Health and Human Services Thursday morning.
With Medicaid increasingly consuming more of the budget each year, the House leadership pushed proposals that send more recipients into managed care. 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.
We must reform and control spending, noted Rep. Matt Hudson, R-Naples, on Thursday. Today one out of six Floridians is in Medicaid and it consumes 28 percent of our total state budget.
The House plan calls for breaking the state into seven regions across the state.
Rep. Rob Schenck, R-Spring Hill, the chairman of the committee, unveiled a number of changes to the measure on Thursday. The changes included moving Indian River County to a region other than originally planned and forcing providers to have more transparency in revealing their relations with one another. The changes also altered the role of electronic medical records.
The Medicaid system is broken; this year alone it will cost the state $20 billion while at the same time failing to ensure access or deliver quality care to participants, said Schenck. The need for reform is urgent --we cannot continue to let these unsustainable costs and inefficiencies in the system continue to plague our states Medicaid program.
The House has carefully pursued reform of the Medicaid program over the last several months, added Schenck.We have worked to improve legislation that was introduced last year by the Select Council by incorporating lessons learned from the five-county pilot program, as well as considering hours of public testimony and following the principles laid out in the Joint Medicaid Memorial that was agreed to by both chambers of the Legislature.
Democrats tried to poke a few holes in the bill. Rep. Elaine Schwartz, D-Hollywood, argued that the pilot programs currently in place simply have not worked. Rep. Mark Pafford, D-West Palm Beach, offered amendments to change the bill but they went down on party-line votes.
Theres a question whether profit will be a main concern or quality of care, said Pafford. I dont think were doing this the right way.
Schenck rejected those arguments and argued that the reforms were patient-centered.
Under this system, more Medicaid patients will be able to see more doctors, more specialists,
Republicans insisted that the current system was broken and that the system had to change.
I think there are a whole lot of positives out of this, said Rep. Gayle Harrell, R-Port St. Lucie, who praised the increased use of electronic records in the bill. Right now the system does not work. It is the most expensive system you can put in place.
The status quo is not acceptable, said Rep. John Wood, R-Haines City. We do have to evolve.
House Majority Leader Carlos Lopez-Cantera, R-Miami, cheered the news that the reform measures passed through the committee.
The Health and Human Services Committees Medicaid reform package will make Floridas Medicaid program more patient-centered, outcome-oriented, and cost-effective, insisted Lopez-Cantera. Our Medicaid system in its current form is unsustainable and is not delivering value for either consumers or taxpayers. Funding for Medicaid is projected to consume almost 30 percent of the total state budget this fiscal year, and its cost will only continue to rise. Meanwhile, carve-outs for special populations, regions, and vendors have made our Medicaid system one of the most complicated in the nation.
Moving to a statewide managed-care program will ensure costs are controlled while delivering better and more stable services to Floridians who depend on Medicaid for their health care needs, added Lopez-Cantera. Through this important legislation, we will bring more accountability to the system, crack down on fraud, and improve patient care.
While both the House and Senate are backing Medicaid reform plans, there are some differences in the two versions. While the measure should pass the chamber, House leaders will have to negotiate with their Senate counterparts on a number of issues.
The Senate bill established creating 19 regions across the state while the House is backing seven. Some Republicans on the committee, namely Rep. Doc Renuart of Jacksonville, seemed willing to increase the number of regions. The Senate also wants to implement the reform a year before the House does. Leaders from both sides have expressed optimism that they will reach an agreement.
Reach Kevin Derby at kderby@sunshinestatenews.com or at (850) 727-0859.
