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Gov. Rick Scott: State will expand Medicaid in Florida

February 20, 2013
The Miami Herald

Saying his mother’s death last year provided “new perspective” on one of the biggest decisions he’s faced as Florida’s governor, Rick Scott announced Tuesday that he will urge the Legislature to accept federal dollars to expand Medicaid.

“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 arranged press conference at the Governor’s Mansion.

The announcement reflects an amazing policy reversal for Scott, who came to politics in 2009 with the sole purpose of defeating President Barack Obama’s health care law and whose spokesman said as recently as June that Florida would not expand Medicaid.

Scott’s endorsement means that as many as 1 million Floridians could gain access to health care, if the Republican-controlled Legislature agrees. That is not a certainty.

“Gov. Scott has made his decision and I certainly respect his thoughts,” House Speaker Will Weatherford, R-Wesley Chapel, said. “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,” said Sen. Joe Negron, R-Stuart, who chairs a Senate committee studying the health care law and who was briefed on the governor’s announcement. Still, Negron said, senators will reach their own conclusion.

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."

Statewide, Medicaid serves about 3.3 million people, with more than half being children and adolescents 20 years of age or younger.

Scott said Tuesday he would support a three-year expansion of Medicaid. After that, the Legislature 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.

Scott talked about the death of his mother and how it helped him make his decision.

“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.”

His endorsement of the Medicaid expansion came hours after the federal government agreed to grant Florida a conditional waiver to privatize Medicaid statewide for the state’s roughly 3 million current recipients.

The two announcements appear linked.

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

Scott and other 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 plan 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.

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.

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

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