MEDICAID

Florida Gov. Rick Scott supports Medicaid expansion

 
WEB VOTE After getting a waiver from the federal government to privatize Medicaid, Gov. Rick Scott now says he will expand healthcare for the poor. A good idea?

MEDICAID IN FLORIDA

Medicaid provides access to health care for low-income families and individuals. It also assists aged and disabled people with the nursing home costs and other medical expenses. Eligibility is usually based on income and assets.

In Florida, the Agency for Health Care Administration (AHCA) is responsible for Medicaid. It is a joint state-federal, government-financed health care program

Statewide, Medicaid serves about 3.3 million people, with more than half are under age 21. About 114,000 individuals or facilities offer health care services to Medicaid recipients. This fiscal year, which ends June 30, the state is expected to spend $21 billion on Medicaid.

Expanding Medicaid could add about 1 million people to the program.


REACTION TO GOVERNOR’S SUPPORT OF MEDICAID EXPANSION

In a reversal of opinion, Gov. Rick Scott announced his support Wednesday for the expansion of Medicaid in Florida. It drew widespread reaction — some positive, some negative. Here’s a sampling:

•  “I’m pleased that the Governor has decided to support implementing the Medicaid expansion component of Obamacare. It has always been a critical facet of ensuring all Floridians have access to quality affordable health care. Of course, I’m disappointed he’s made the irresponsible decision to agree only to the expansion for the next three years while the federal government is footing 100% of the cost. That’s not the certainty or leadership Floridians need. And while it’s good news for Florida that Medicaid coverage will be expanding, I’m deeply concerned about the governor’s plan to go statewide with a managed-care pilot program that has had mixed results when tested in a few Florida counties, including Broward. We need strong and enforceable safeguards in place to protect the quality of health care for Medicaid recipients."

- U.S. Rep. Debbie Wasserman Schultz, D-Weston, and chair of the Democratic National Committee

•  “Regardless of where any individual stood on the Affordable Health Care Act on Election Day, the dilemma facing policy leaders and businesses resolving the challenges of the future of health care policy in Florida is enormous. AIF will continue to encourage the Legislature to best utilize federal funding to provide coverage to more Floridians in a manner that best safeguards Florida’s citizens and protects its financial health. As these discussions continue, AIF will continue to advocate for a thoughtful and deliberative approach to ensure that Florida’s businesses do not continue to be saddled with the enormous tax bill of the uninsured that hampers economic growth and job creation.”

Tom Feeney, president and CEO of Associated Industries of Florida (AIF).

•  “People’s heads are probably exploding at tea party headquarters across the country, and that’s because we may have just witnessed a crucial turning point in the Republican’s hyper-partisan opposition to the Affordable Care Act. If there was ever any question that Obamacare would be fully implemented, we got the answer today from one of the leaders of the anti-Obamacare movement. Rick Scott has disregarded his own orthodoxy and put responsible governing over reckless partisan politics and extremism. Scott came around to what everyone has known all along: accepting federal funds to extend Medicaid to 1.3 million Floridians is good for hospitals, businesses, state and local governments and, most importantly, the people who need health care. This is a good day for health care and for all Americans who believe solving problems is more important than scoring political points.”

- Ethan Rome, executive director of Health Care for America Now.

•  “The National Women’s Law Center applauds Governor Rick Scott for his support of the expansion of health coverage through the Medicaid program. Now about 613,000 Florida women stand to gain the security of quality health coverage and the ability to get the care they need, when they need it, without facing huge medical bills. Combined with other reforms in the Affordable Care Act, this expansion would reduce the percentage of uninsured women in Florida from 25.3 percent to 5.8 percent. Women covered through the Medicaid expansion will receive a comprehensive set of health benefits, such as mammograms, preventive health screenings, and treatment for chronic conditions. In addition, women and their families will enjoy greater economic security—people with Medicaid coverage are less likely to ignore other bills or borrow money to pay medical expenses than people without health coverage. When women have health insurance, the entire family can better manage its health—for example, children can get their asthma medications, and mothers can manage their high blood pressure.

- Judy Waxman, NWLC’s Vice President for Health & Reproductive Rights

•  “Governor Scott’s announcement today is extremely disappointing. Governor Scott had been a national leader in the fight against President Obama’s healthcare takeover. He was elected because of his principled conservative leadership against ObamaCare’s overreach, and led the charge, with Attorney General Pam Bondi, to take ObamaCare to the Supreme Court. But today he came out in support of the Medicaid expansion he vowed to oppose. At every level of government, it is too easy for politicians to spend other people’s money. For far too long, states have fallen for the promises of “free” federal money ignoring the insidious federal strings and the long-term effects on state budgets. Florida’s Medicaid program already costs the taxpayers more than $20 billion a year, and the financial burden will only grow if a million new people are added to the program. Hopefully our legislative leaders will not follow in Governor Scott’s footsteps and will reject expansion of this broken system.”

- Americans for Prosperity-Florida’s State Director Slade O’Brien.

•  “Today, following President Obama’s lead and the overwhelming will of Floridians, Rick Scott finally abandoned his crusade to block affordable health care for Florida’s families and accepted the expansion of Medicaid. We hope and expect that Republicans like Rep. Will Weatherford and Sen. Don Gaetz, who have stood with Scott to consistently stall its implementation, will soon follow suit.”

- Florida Democratic Party Chairwoman Allison Tant

•  “The only reason to expand Medicaid would be if one believes Medicaid is in fact a good system for the delivery of health care services. I believe it’s a very flawed system, and I prefer to think about ways to get people off of Medicaid than to get more people on it.”

- Rep. Matt Gaetz, R-Shalimar

•  “The Governor has come to recognize that we have a responsibility to help those that have no access to even primary care. My hope is my colleagues in the Florida Legislature will do the same for the little guy and gal of Florida.”

- Rep. Mike Fasano, R-New Port Richey

•  “The Florida Chamber congratulates Gov. Scott and the Legislature on today’s second waiver which gives our state flexibility moving forward. As Florida begins evaluating different proposals to the expansion of Medicaid, the discussion should focus on the economic benefits and the future costs to Florida. Will expanding Medicaid make Florida more competitive?”

- David Christian, Florida Chamber of Commerce’s vice president of government affairs

•  “I would prefer that the governor embrace the Affordable Care Act without constraints, such as his newly proposed automatic three-year sunset of expanded Medicaid coverage. Regardless, his comments today are a step forward that I urge Republican legislative leaders to meet with action.”

- Rep. Perry Thurston, House Democratic Leader, from Plantation

•  “Gov. Scott is interested in getting re-elected and has terrible poll numbers. No doubt part of this decision has to do with his wanting to get re-elected. When politicians do what they feel they must to get re-elected instead of doing what they know is right, they often lose re-election and, even when they do not, lose their way. It is a sad day for conservatives.”

- Erick Erickson, RedState.com and conservative pundit


Herald/Times Tallahassee Bureau

Gov. Rick Scott said Wednesday he supports expanding Medicaid and funneling billions of federal dollars to Florida, a significant policy reversal that could bring health care coverage to 1 million additional Floridians.

“While the federal government is committed to pay 100 percent of the cost, I cannot, in good conscience, deny Floridians the needed access to health care,” Scott said at a hastily called news conference at the Governor’s Mansion.

Scott, a former hospital executive, spoke with unusual directness about helping the “poorest and weakest” Floridians — a stunning about-face for a small-government Republican who was one of the loudest voices in an aggressive, and ultimately unsuccessful, legal strategy to kill a law he derided as “Obamacare.”

Throughout his 2010 campaign for governor, as Scott sought support from tea party members, he called the law a “job-killer” that would hurt Florida.

On Wednesday, he called the proposed Medicaid expansion, at least for an initial period, “common sense.”

Tea party activists bitterly criticized Scott’s declaration.

“This is just another example of Republicans lying to Floridians,” said Everett Wilkinson of Palm Beach Gardens, calling Scott “the Benedict Arnold to the patriot and tea party movement in Florida.”

Scott was careful to point out that the Republican-controlled Florida Legislature will ultimately decide whether or not his proposal is worth implementing. That is far from certain, particularly in the more partisan House.

“Gov. Scott has made his decision and I certainly respect his thoughts,” said House Speaker Will Weatherford, R-Wesley Chapel. “However, the Florida Legislature will make the ultimate decision. I am personally skeptical that this inflexible law will improve the quality of health care in our state and ensure our long-term financial stability.”

“I respect the governor for staking out a clear position,” added Sen. Joe Negron, R-Stuart, who chairs a Senate committee studying the health care law. He said senators would reach their own conclusions likely in early March.

In Miami, Carlos A. Migoya, Jackson’s president and chief executive officer, applauded Scott’s announcement. “Anything that provides coverage for our currently uninsured residents certainly advances our community and Jackson Health System’s mission,” he said. “The impact on Jackson’s budget, however, will be based on how the details are written and how the funding is allocated."

Scott said he would support an initial three-year expansion of Medicaid but made clear he would not twist legislators’ arms to make it happen. He reiterated that his top priorities are a $2,500 pay raise for teachers and a sales tax break for manufacturers’ equipment purchases.

Under the governor’s proposal, the Legislature — after three years — would have to vote to reauthorize the program to keep it going.

“It is not a white flag of surrender to government-run health care,” he said, as if anticipating a political backlash from his most conservative supporters.

Part of his self-described “new perspective” came from the death of his mother Esther last year, he said.

“A few months ago, my mother passed away, and I lost one of the only constants in my life,” Scott said. “Losing someone so close to you puts everything in new perspective ... especially the big decisions.”

For weeks, Scott has said the debate on expanding Medicaid was directly tied to the state’s application for waivers it needs to allow private companies to run the program.

His endorsement of the expansion came hours after the federal government agreed to grant Florida a conditional waiver to privatize Medicaid statewide for the state’s more than 3 million current recipient, more than half of whom are children or people under age 21.

Scott and GOP lawmakers have repeatedly warned that Medicaid’s roughly $21 billion annual costs were consuming Florida’s budget and proposed the managed care plan to save money and improve care.

The privatization expands on a five-county pilot program that has been rife with problems. Critics worry for-profit providers are scrimping on patient care and denying medical services to increase profits. Some doctors have dropped out of the pilot program, complaining of red tape and that the insurers deny the tests and medicine they prescribe. Patients have complained they struggled to get doctor’s appointments. The participating counties included Broward.

Several health plans also dropped out of the pilot program, saying they couldn’t make enough money. Patients complained they were bounced from plan to plan with lapses in care. Nearly half of the 200,000 patients enrolled in the pilot have been dropped from at least one plan, federal health officials noted at one point during negotiations.

Lawmakers say they have fixed the pilot program’s shortcomings, with provisions including increased oversight and more stringent penalties, including fining providers up to $500,000 if they drop out. The measures also increase doctors’ reimbursement rates and limits malpractice lawsuits for Medicaid patients in hopes of increasing doctor participation in the program.

Medicaid, a joint state-federal, government-run health care program, is voluntary for states. But every state participates, in part because of the good financial terms. The federal government covers about 55 percent of all Medicaid costs in Florida and covered about 68 percent in recent years with additional stimulus funding.

The health care law tried to entice states to expand eligibility to Medicaid by raising income eligibility limits. To do so, the federal government agreed to fund 100 percent of the cost for states to expand Medicaid for three budget years. The federal government would then cover 95 percent of the costs in 2017, 94 percent of the costs in 2018, 93 percent of the costs in 2019 and 90 percent of the costs in 2020 and beyond.

Recent polls conducted by the American Cancer Society’s Cancer Action Network and the Florida Hospital Association indicated that most Floridians supported the Medicaid expansion, though conservatives were less likely to agree.

Scott said Wednesday that he had to look past his long-standing opposition to the health care law to reach his decision.

“It doesn’t matter what I believe. It doesn’t matter what anybody believes,” Scott said. “The Supreme Court’s already made their decision. We had an election in the fall, and the public made their decision.”

Miami Herald reporter John Dorschner and The Associated Press contributed to this report.

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