The Florida Influencer Series

Health care: Increase access to care by expanding Medicaid and considering subsidies

Florida Priorities: What Florida wants

Aminda Marqués Gonzalez and George Haj talk with Cindy Arenberg Seltzer, Julie Wraithmell, Rhea Law, Chris Caines and Victoria Kasdan during the Florida Priorities event at the University of Miami on November 14th, 2018.
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Aminda Marqués Gonzalez and George Haj talk with Cindy Arenberg Seltzer, Julie Wraithmell, Rhea Law, Chris Caines and Victoria Kasdan during the Florida Priorities event at the University of Miami on November 14th, 2018.

Chairman: VICTORIA KASDAN. Members: MARLON HILL, JEFF JOHNSON, JARET DAVIS, SHELLEY KATZ, AL CARDENAS

THE QUESTION: How should Florida’s elected leaders reduce health care costs and increase access to care?

Summary of the survey findings of 50 Influencers:

The Florida Influencers ranked expanding Medicaid under the Affordable Care Act as the top healthcare priority in the state. Asked to rank six proposals to address health care concerns by order of importance, about 70 percent said Medicaid expansion should be at the top of the list.

As for some of the other potential solutions, 16 percent of the Influencers rated creating a national “Medicare for All” system first, while another 16 percent went in the other direction, saying repealing the ACA completely is the most important healthcare issue facing the state and the country.

Proposals to restore Obamacare to its original form and strengthen anti-abortion laws in the event of the Supreme Court overturning Roe v. Wade were the top concerns for less than five percent of the Influencers. And only one Influencer said doing little, because current healthcare programs are sufficient, was the best approach.

Additionally, most Influencers did not see providing universal health care in a financially responsible way as as a realistic possibility in the short term.

Statement summarizing the views of the working group regarding the issue:

Healthcare is top of mind for many Floridians, whether they are concerned about protection for pre-existing conditions, care for the uninsured or cost of care in general. All Floridians are affected directly or indirectly because of lack of healthcare access. There is a high cost to do something -- and a high cost of not doing enough.

Simply reducing the number of uninsured will not address the core issues of high cost and limited access. We recommend solutions that will allow for individual liberty yet find ways to deliver more healthcare at less cost in a compassionate manner.

FLORIDAINFLUENCERSwtbepf
Florida Influencers Al Cardenas (center) joins other Inflencers to discuss healthcare in a breakout session on Tuesday, November 13, 2018 during the Florida Priorities Summit at the University of Miami. The Florida Influencer Series, is the beginning of a conversation among leaders, decision makers, and voters to put a sharp focus on a shared vision for Florida. PATRICK FARRELL pfarrell@miamiherald.com

Potential solutions:

  • Expand Medicaid in Florida and draw down federal dollars to insure Floridians. Include protections in place in case federal funding drops below a certain threshold and leave eligibility criteria as it is for the time being. Consider subsidy options or premium reductions to bridge those who fall within 101 percent to 138 percent of the federal poverty level.
  • Revise the use of the Low Income Pool, which reimburses hospitals for care given to uninsured patients. While continuing to fund hospitals that care for the indigent population, allow the money to follow the patient rather than simply for retrospective payments to hospitals. Add accountability measures to ensure that the money is being properly spent.
  • Fund demonstration projects across Florida to test new ideas for improved care, increased access, and reduced costs.

What questions will the new governor and legislature need to answer to make progress on this issue?

  • What is the cost of doing something versus doing nothing? Use data analytics to do an analysis.
  • Where is the low hanging fruit and opportunity to reduce cost and increase access.?
  • What standards do we add to ensure quality, for example, standard protocols for electronic medical records?
  • How do we protect medical data and keep cyber-criminals from stealing information or demanding ransom?

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