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Bush, officials discuss revamping Medicaid

Associated Press
Published April 5, 2005

JACKSONVILLE - For 11-year-old Marisselle Quinones, who has spina bifida, Gov. Jeb Bush's plan to switch 2.2-million vulnerable, disabled and elderly Floridians on Medicaid to privately run managed health care plans is personal.

Marisselle, seated in a wheelchair, read a letter to the governor Monday at a forum on Medicaid reform outlining her concerns about receiving money for colostomy bags and treatment under Bush's proposals. She was worried that she would be hurt by changes in the existing program.

"I want to be independent," said the little girl, who was accompanied by her mother, Maria.

Other speakers at the forum included Alan Levine, secretary for the Agency for Health Care Administration; doctors, hospital administrators, other Medicaid patients and members of the Legislature.

Bush told the little girl and her mother she would still be cared for under his plans to revamp the system.

"The most vulnerable population will be the last ones phased in this program," the governor assured the girl.

In January, Bush asked the Legislature to completely change Medicaid, suggesting it shift the program to one that is more like private managed care to rein in growing costs.

Bush is proposing that the state take the money it typically gives doctors, hospitals or other providers to treat Medicaid patients and pay it as a premium to a managed care network to take on the patients. Patients could be in health maintenance organizations, community-based networks, or be covered by other private insurance.

Medicaid now takes up about $1 of every $4 in the state budget. While the amount of tax dollars coming in has increased by 24 percent since 1998, Florida's Medicaid costs have grown by 88 percent. The number is growing at more than 13 percent per year.

Under Bush's Medicaid proposal, health plans must offer certain benefits, but they decide the level of those benefits moneywise and timewise, and patients pick their health plan.

"If Medicaid is growing at 131/2 percent a year, it crowds out almost everything else," Bush said Monday.

"The whole process needs to be reviewed and revised," Bush said. "We can develop a much better system."

The governor was joined by state Reps. Holly Benson, R-Pensacola, Aaron Bean, R-Fernandina Beach, and Mark Mahon, R-Jacksonville.

"For millions of Floridians, the way Medicaid works isn't policy, it's personal," Benson said.

Bush said he is considering pilot programs in Jacksonville and surrounding area and in the Miami area that would start by March of 2006.

Bush said any changes Florida makes to the Medicaid program would have to be approved by both the Legislature and the federal government. Federal dollars cover about 60 percent of the state's Medicaid program.

While committees in the House and Senate are working on legislation to spell out some changes to the program, it's becoming clear that no wholesale changes will take place any time soon.

[Last modified April 5, 2005, 01:30:21]

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