FMA to feds on Medicaid waiver: please reject this proposal

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That news comes via the Health News Florida website:


In a meeting that was closed to the press, FMA leaders passed a resolution Sunday to discourage the federal Centers for Medicare & Medicaid Services from approving a waiver that would allow the state to move hundreds of thousands of poor and elderly beneficiaries into HMOs and other managed care plans.


“The letter will explain that we understand the budget constraints of the Legislature, but we cannot approve of expanding managed care,” said Dr. Miguel Machado, FMA president.


Perhaps the biggest problem is that there still not definitive news if the five county plan, five years later, it remains unclear if Bush's Medicaid Reform proposal worked. As the St. Pete Times Marc Caputo reported earlier this year,


Preliminary studies suggest that costs are marginally lower, patients are scoring relatively higher on a checklist of state health indicators and patient satisfaction with care isn't that much different.


During the legislative session, the top Democrat in the state Senate, Nan Rich, said,"I have a major problem with doing a massive expansion of a managed-care experiment that, four and a half years later, we don't know if it works."


Medicaid is a joint health care system for low-income people whose costs are shared by the states and the federal government. In the past 11 years, the cost of Medicaid in Florida has grown to $21 billion from $9 billion and amounts to a third of the state budget.


The state intends to begin the program (if given the go-ahead from Washington) by enrolling the elderly by October 2013.

  • South Florida Democrat Nan Rich

Among the many achievements that Republicans in Tallahassee have boasted about after this year's Legislative session ended in May was that they achieved Medicaid reform.

In fact, they still haven't achieved that goal of reducing long-term costs by turning over nearly all of the management of the system to HMOs and other managed-care companies throughout the state, because they need the federal government to sign off on such a plan.

The plan would put nearly all of the state's Medicaid three million patients into a into state-authorized, for-profit H.M.O.’s or networks run by hospitals or doctors. H.M.O.’s or networks would also manage the long-term care of the elderly, shifting them away from nursing homes and leading to an expansion of in-home care.

State GOP leaders going back to Jeb Bush have pushed for such a privatization of Medicaid, with the former governor introducing a controversial plan back in 2006 that was limited to a five-county experiment in Broward County and the Jacksonville area.

On Sunday the Florida Medical Association voted to publicly oppose the proposed Medicaid overhaul and write a letter of concern to the federal government urging them not to give Florida a waiver.

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