Florida Senate Pu shes Medicaid Reform

April 1, 2010

The state Senate shifted rightward Wednesday by pushing plans to give private companies more tax money to manage prison operations and healthcare for the poor.

As debate over the state budget began in earnest, the one-two privatization punch drew opposition from Democrats. They managed to soften the blow to the public prison system — job cuts had been on the table — but failed to halt a sweeping change for the Medicaid program that Republicans proposed in reaction to President Barack Obama’s signing of the new healthcare reform law.

In the end, senators unanimously adopted a budget proposal, backing off a controversial plan to save money by opening a privately run prison and closing two state-run lockups.

The Senate budget would allow the 2,200-bed, $113 million private Blackwater River prison in Milton to open Nov. 1. It would be run by the GEO Group and its cellblocks filled with inmates from other state-run prisons.

The House has not yet approved a budget proposal.

“Prisons won’t be closed and officers won’t lose their jobs,” said David Murrell of the Florida Police Benevolent Association, the guards’ union that initially faced the loss of more than 600 jobs.

The Medicaid privatization effort, also wrapped into the Senate’s proposed $69.4 billion budget, passed despite Democratic concerns about restructuring Medicaid, a nearly $19 billion state-federal health program for the poor that serves 2.7 million people, or 14 percent of Florida’s population.

Republican Sen. Joe Negron of Stuart, part of a wave of new conservatives in the Senate, sponsored the bill he called the “transformation of how Medicaid works” because the program’s costs and rolls are climbing and Obama’s healthcare plan could add 1.8 million more people to the Florida rolls by 2019.

“I don’t think we can afford to wait,” Negron said. “The reason we can’t put money into education, we can’t put money that we want into other areas of the budget is because the way Medicaid works now is they [federal officials] just come and hand us an invoice: `You owe us $1.8 billion this year. You owe us $2 billion.”’

In recent years, the Senate was a more moderate body that would put the brakes on conservative education and healthcare policies, but no more. They’re flying out of the Senate this year.

In just 168 words that had never before been publicly debated in the Legislature, Negron and two top Senate leaders — Mike Haridopolos and Don Gaetz — proposed the language that would transform Medicaid by capping its yearly budget, changing some benefits, instating co-pays and deductibles, and giving recipients vouchers so they can buy private insurance.

The Medicaid changes are not guaranteed. They must be approved by the federal government. And the state House did not take up a similar proposal as it began debate on its proposed $67.2 billion budget Wednesday.

Though Republicans have fretted about the cost of Medicaid, the state’s proportion of the health program’s costs have actually declined in recent years because of federal stimulus money. Also, the Legislature last year transferred $1.8 billion in state and federal money that would have gone to Medicaid to plug other holes in the budget and avoid raising more taxes.