State Politics

Medicaid revamp faces obstacles in Tallahassee

FORT LAUDERDALE — With Medicaid costs now consuming 26 percent of the state budget, the upcoming session seems primed for a program overhaul. But legislators will tackle the issue amid a foundering pilot program, a class-action Medicaid lawsuit that could cost the state millions, all while waiting to see if and how a federal health bill will affect the state.

Reining in the program for low-income and disabled patients has been discussed, with little change, for years. But with Florida’s sour economy driving Medicaid enrollment to an all-time high, lawmakers say they have no choice this session.

The state expects to pay $17.9 billion to serve 2.6 million recipients — one out of every seven residents — and an 11 percent increase from last year.

“At the current trend line Medicaid spending is unsustainable. We simply can’t afford to do it the way we’re doing it now,” said Rep. Matt Hudson, R-Naples, vice chairman of the Health & Family Services Policy Council.

Despite widespread complaints from patients and doctors and unflattering reviews from various studies, expanding Florida’s Medicaid reform program is still a viable choice, especially after Gov. Charlie Crist said he’s open to broadening it. The governor has not offered support for any of the existing ideas being discussed, according to Crist’s spokesman Sterling Ivey.

Under the pilot program, which is in five counties including Broward and Duval, the government pays private companies a set amount for handling a specific number of residents — similar to a health maintenance organization in the private sector. The companies, in turn, decide how to care for the patients, including which doctors they can see and what medicines and treatments can be prescribed.

Senate President Jeff Atwater, R-North Palm Beach, says he supports expanding the program because it has dealt with escalating prices and changed behaviors by setting up patients with a primary care doctor to prevent unnecessary emergency room visits.

He said the Legislature should discuss how the program should be modified and what counties should be included next.