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Florida to expand Medicaid under health overhaul

Published on NewsOK Modified: February 20, 2013 at 5:22 pm •  Published: February 20, 2013

Scott's announcement came hours after federal health officials said they plan to approve the state's longstanding request to privatize its Medicaid program statewide if they agree to beef up transparency and accountability measures. He said that decision signaled that feds were willing to work with the state to give them the flexibility they need.

The other six GOP governors who plan to expand the program are the leaders of Michigan, Ohio, Arizona, New Mexico, Nevada and North Dakota. So far 21 states plus Washington, D.C., plan to expand their Medicaid programs under the health care law. Fourteen states have said they'll turn it down, although the debate is still going in several of them. Another 15 are weighing options.

Under the federal law, states were given the choice of whether to expand Medicaid to people whose incomes equal 138 percent of the federal poverty level — about $15,000 for an individual and $32,000 for a family of four.

Florida has one of the highest rates of uninsured residents in the country and some of the most stringent eligibility requirements. A family of three with income of $11,000 a year makes too much and single residents are not covered. The bulk of residents getting coverage under the Medicaid expansion will be childless adults.

The federal government's offer to cover most of the cost of expansion is much more generous than the roughly 50 percent matching rate that federal health officials currently pay for Medicaid. The state spends about $21 billion a year to cover roughly 3 million patients — about half are children.

Florida hospital officials have said the state would receive about $26 billion from the federal government to pay for Medicaid expansion over the next decade. That would be a huge boon to hospitals that are losing other federal funding sources for uninsured patients under the federal health law.

Advocates said Medicaid expansion will bring about 54,000 new jobs to the state and have a significant impact on Florida's tourism and hospitality industries.

Hospital executives have said the expansion will significantly reduce the amount of money spent covering uninsured patients by hospitals, insurers and taxpayers by allowing patients to get coordinated treatment whenever they need it instead of waiting to go to the emergency room.

The new Medicaid population will get coverage under the privatization proposal that federal and state health officials are still hammering out. The program would allow for-profit providers to determine the health care for Medicaid recipients with the goal of saving money and improving services

Federal officials are insisting on enhanced accountability measures by requiring the state to use real-time data that evaluates whether the program is actually improving patient care along the way as promised, not just at yearly benchmarks. The state must also hold regular meeting with health advocates, patients and insurers and hire an ombudsmen to oversee the portion of the program that involves tens of thousands of elderly, long-term care patients.


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