By John Kennedy
The News Service of Florida
The House will unveil a wide-ranging, multi-year effort Tuesday to revamp Florida’s costly Medicaid program – a plan that surpasses the Senate’s already ambitious approach to expand managed-care coverage for low-income Floridians, according to those familiar with the proposal.
The House plan is emerging publicly for the first time past the session’s midpoint, in keeping with a strategy that last year had Speaker-designate Dean Cannon, R-Winter Park, float an offshore oil-drilling proposal as a multi-billion dollar budget balm in the session’s waning days.
But unlike oil-drilling, which languished, the Medicaid plan is likely to prove a pivotal factor in the Legislature’s end-game.
“We’re not going to let the status quo rule,” said Sen. Mike Haridopolos, R-Merritt Island, the incoming Senate president who is central to that chamber’s push for adding 250,000 Medicaid patients to managed care plans in 19 counties, building on a five-county pilot program approved by lawmakers in 2005.
“If you don’t make these kind of reforms, Medicaid is crippling our state. If we move away from fee-for-service, which is fraud-ridden, and we move toward a model where we’re telling people they have some accountability, and they’re going to have some choice, and if they do the right thing, there’s going to be incentives in place, that’s a winning idea,” Haridopolos said.
Like the Senate, the House proposal includes HMOs. But politically, the House plan also looks to defuse opposition by including provider-service-networks led by hospitals and doctor groups in the Medicaid overhaul.
Such PSNs have been credited by University of Florida analysts for reducing per-patient costs in the Broward, Duval, Baker, Clay and Nassau counties, where the pilot Medicaid reform program began 2006 and 2007.
“We’re looking at an expansion of managed care statewide,” Cannon told the News Service of Florida. “But not all at one, instead over several years.”
The House Select Policy Council on Strategic & Economic Planning, which Cannon chairs, is scheduled to workshop the Medicaid rewrite Tuesday evening, with an almost three-hour session.
Although Florida’s Medicaid pilot was scarred by some HMOs dropping out of the program, forcing patients to struggle to find new coverage, managed-care advocates have played a powerful role in shaping the Senate’s collective thinking.
Haridopolos and Sen. Don Gaetz, R-Niceville, traveled last fall to Washington where they met with officials from the conservative Heritage Foundation, U.S. Chamber of Commerce, and the Mercatus Center at George Mason University. They were urged to develop a plan that would give the state more authority over Medicaid spending.
Two political committees controlled by Haridopolos, the Committee for Florida’s Fiscal Future, and the Freedom First Committee, also were on the receiving end of major donations from organizations either opposing Congress’ expansion of Medicaid coverage or those seeking to play a bigger role in Medicaid HMOs.
The U.S. Chamber of Commerce, which gave Haridopolos’ Freedom First organization $225,000 last summer, has warned that President Obama’s new Medicaid/Medicare czar, Donald Berwick, has sparked businesses to be “on red alert for radical changes that could significantly impair the ability of America’s job creators to compete.”
Managed care companies contributing to Haridopolos’ Committee for Florida’s Fiscal Future include Humana, ($25,000) and Preferred Medical Plan ($12,500). Wellcare of Florida ($10,000) and Preferred Care Partners Holding Corp., ($20,000), made their contributions to the committee the day before the Legislature convened in March, records show.
The House is tilting its plan more toward building on the five-county pilot program than the Senate – which goes so far as to request a federal waiver to break free from many current Medicaid standards and create a Florida-focused program that requires patients to meet deductibles and co-payments, while also getting vouchers to shop around for private care.
Cannon said the House plan doesn’t embrace the vouchers’ idea – and doesn’t likely need a federal waiver to advance, at least in its early stages.
