With the clock ticking on Florida’s ability to control how it applies the federal Patient Protection and Affordable Care Act, pediatricians say they’ve been trying to meet with the agency that oversees the state’s Medicaid program --- to no avail.
The Agency for Health Care Administration last month declined a request from the Florida Pediatric Society to discuss how the state will implement those aspects of the federal health-care overhaul that relate to children.
"Whatever program is ultimately designed, there are risks where children could fall through the cracks in a system that’s really oriented to adults," said former state lawmaker Sam Bell, a lobbyist for the pediatricians’ group. "So we bring the kind of expertise that will highlight not only where those cracks occur but the kind of care that needs to be mandated as part of the system."
AHCA, however, refused the meeting because the Florida Pediatric Society is suing them over another matter.
According to an Aug. 29 letter from the state attorney general’s office, AHCA Secretary Elizabeth Dudek "respectfully decline[d]" the meeting due to a pending class-action lawsuit brought by the pediatricians’ group against Florida Medicaid, which AHCA oversees. Dudek is one of the defendants.
The pediatric society, which represents roughly 2,500 pediatricians, joined with parents and other providers to charge the state with being out of compliance with federal law, which guarantees Medicaid children prompt and equal access to medical and dental care.
Critics say Florida performs poorly in delivering medical and dental care to Medicaid children, and the state continues to have one of the largest percentages of uninsured children – roughly half a million.
The lawsuit, first filed in 2005, could cost the state $1 billion if federal district Judge Adalberto Jordan rules for the pediatricians and their fellow plaintiffs. His ruling could come any day.
Bell, however, said the lawsuit is just an excuse for the Scott Administration not to move on the federal health law, which is widely known as the Affordable Care Act. He noted that the pediatric society had met with the former secretary of the state Department of Health, John Agwunobi, while the suit was pending.
Officials from AHCA and the governor’s office said they would respond Thursday.
Scott has long made clear his opposition to the federal health care law. After the U.S. Supreme Court declared most of the act constitutional in June, Scott said he would keep Florida out of optional parts of the law, such as an expansion of Medicaid eligibility. He also said the state will not create an insurance clearinghouse, known as a health exchange.
Health exchanges are key components of the Affordable Care Act, providing individuals not covered by their employers a way to choose from a list of approved insurance plans. If states don’t implement exchanges, the federal government will.
"We’re not going to implement the health care exchanges because it’s not going to drive down the cost of health care," Scott said in July. "It’s going to raise the cost."
The pediatric society, however, wants the state to determine its own policy so that Florida pediatricians can be part of the planning.
"We want to be part of the solution," Bell said. "That’s why it’s important for us to be at the table."
The pediatric society said the Affordable Care Act raises a series of children’s issues. They include amending the state Medicaid plan and managed care contracts; implementing higher Medicaid reimbursement rates for physicians and dentists; achieving higher vaccination rates; and establishing health benefits that meet children’s needs.
States have until Nov. 16 to send the federal government letters stating their intentions going forward.