Florida's Medicaid proposal could put $24 billion from feds at risk
Florida officials plan to privatize Medicaid and cut benefits even as some federal officials worry they are jeopardizing about $24 billion in federal health reform subsidies. That's equivalent to almost a third of one year's entire state budget.
State Sen. Joe Negron, R-Palm City, plans to unveil the Florida Senate's plan for reining in Medicaid costs today .
The health care overhaul law promises that Washington will pay the tab for additional poor Floridians joining Medicaid between 2014 and 2019. The Kaiser Family Foundation estimates that Florida will receive $24 billion in new federal support during those years.
This is why: According to Kaiser, 1.3 million newly eligible people are projected to flood Florida's Medicaid program in 2014, joining the 2.8 million already on Medicaid. The Affordable Care Act says anyone who earns up to 133 percent of the federal poverty rate, or about $14,000 a year for an individual, will suddenly qualify for the health safety-net program that year. In Florida, non-disabled childless men, who currently are barred from Medicaid, will be the biggest beneficiaries. (Illegal immigrants are not among those covered.)
This change alone will cut the state's 4 million uninsured by 44 percent, Kaiser projects. Because the feds will pay nearly all of the new enrollees' costs through 2019, flouting the health law mandates would cost the state billions.
The act says that to receive the payments, states must keep up 2010 Medicaid benefit levels through 2014.
That's not going to happen, Negron says.
The economic downturn is causing Medicaid costs to soar past $20 billion in 2011 in Florida, although the U.S. government pays more than half.
But with state revenues shrinking, states must have flexibility to react, Negron said.
"We understand that issue, but we cannot allow Washington, D.C., to commandeer our budget," said Negron, who is chairman of the Senate Budget Subcommittee on Health and Human Services Appropriations. "My goal is the benefits under Medicaid will not be worse than what any private citizen has, but not better, either."
In broad sketches, the Senate plan would give most Medicaid participants coverage with a private insurer or a qualifying hospital-based medical network such as the South Broward Hospital District, which runs Memorial Regional Hospital in Hollywood.
The private coverage would have to meet minimum standards and cover basics. But extras the state now pays, such as dental, ophthalmology and some mental health services, likely would be gone.
"What we did in the Senate was start with a blank sheet of paper and devise a Medicaid plan from scratch," Negron said. "We have the right to have certainty on what we are going to spend each year on Medicaid."