State Overhaul of Medicaid Might Run Out of Time
April 21, 2010
With less than 10 days left before the legislative session ends, an aggressive House plan to overhaul Medicaid may be in trouble.
Gov. Charlie Crist said Tuesday afternoon that he had "concerns" about the proposal, which would shift nearly all 2.7 million Floridians on Medicaid to HMOs and other private managed-care plans or organizations. That would, for the first time, mean that private contractors would manage even the care of seniors in nursing homes and people with developmental disabilities.
Crist said he had just had a briefing on the proposal, which passed the House on Monday. "I do have concerns about it, as it relates to the most vulnerable in our state and our society, as well as seniors."
The governor said he intends to meet today with representatives of AARP and other advisors about those issues.
Crist cited concerns about students with developmental disabilities last week when he vetoed Senate Bill 6, a contentious education reform bill. Asked Tuesday if he might veto the Medicaid bill as well, Crist said that depends on the final proposal’s form.
Crist made his comments hours after House and Senate lawm akers met for the first time to discuss the Medicaid plan.
For more than an hour, Republican Sens. Don Gaetz, Joe Negron, and Durell Peaden peppered Speaker-designate Dean Cannon and other House members during the informal meeting with questions on a range of issues, from predicted cost savings to quality of patient care.
The proposal has competition, as the Senate advanced its own, simpler proposal earlier in the session to expand a managed-care Medicaid pilot program to 19 counties, including those in the Tampa-Bay area. Peaden, R-Crestview, said the Senate still considers that plan an option.
An alternative proposal, which has also passed the Senate, would entail asking federal officials for permission to transform the entire Medicaid program into a voucher program for purchasing private insurance. Negron, an architect of the latter plan, made clear he’s not interested in giving up on it, asking pointedly whether the House plan would prevent that idea from moving forward.
Cannon and House staff said it would not. Negron, R-Port St. Lucie, said afterward that he remains undecided about pursuing such far-reaching proposals simultaneously.
While the senators at Tuesday’s meeting were largely complimentary of the House’s ideas, Senate President Jeff Atwater hinted that time may run out for the proposal to pass in his chamber.
"I give them a lot of credit; I wish it had come sooner," said Atwater, R-North Palm Beach. "It’s pretty complex, and they went through a tremendous amount of effort … now, we’ll look at it, the next couple days, but time is short."
Atwater said he appreciated the "boldness" of the House proposa l to rein in costs and reduce fraud. But aggressive reform of the mammoth $19-billion program, he said, "may take some significant focus, uniquely on Medicaid — for months."