Florida reforms health care for the poor to save money

Florida lawmakers passed a sweeping Medicaid reform package that places most recipients into managed care in a closely watched debate over how to curb costs and provide health benefits to the poor.

Following hours of debate and back-room negotiations over the past several weeks, the Republican-dominated Legislature late on Friday sent a package to Governor Rick Scott that backers say will save the state $1.1 billion next year.

Savings would be realized by shifting Medicaid from a traditional fee for service program to one that caps payments to providers and more closely mirrors private sector health insurance plans.

The bill would split the state into 11 regions and allow managed care companies to compete for business within those geographic boundaries.

Backers say the shift will reduce costs of health care for some 2.9 million recipients in the state's $22 billion federal program, without compromising care.

"This bill does what it should do. It treats our friends and neighbors who receive Medicaid with integrity, respect and we let them control their destiny," said Republican Sen. Joe Negron, a sponsor of the bill.

Like other states, Florida's Medicaid tab continues to gobble up a greater percentage of state spending and now accounts for nearly a third of the state's $69.7 billion budget.

While the federal government pays about 60 percent of benefits, the state's tab has also risen and backers fear the state's share of payment could go up if the federal match returns to historic levels.

The state has operated a pilot project in five counties with mixed results.

A review of the pilot program in 2009 found that it did not have a significant impact on the quality or access to care. Reviewers determined that changing the delivery system of Medicaid benefits was a policy decision that would significantly alter the level of care.

Critics say the reform measure was much improved during the legislative process but will still make it more expensive for low-income Medicaid recipients who will also face higher out of pocket expenses for emergency room care.

The reforms also will require some disabled recipients to navigate the managed care system.

"As we move forward with this statewide legislation, I hope the proponents will recognize these flaws and concerns," said Rep. Mia Jones, a Democratic opponent of the bill.