Managed care for Medicaid approved

As the House okays its bill, Senate Democrats plan to call attention to big companies that get tax breaks but don't provide health coverage.

Associated Press
Published May 3, 2005

TALLAHASSEE - The Florida House passed a bill Monday that would start the process of revamping the Medicaid system, the 40-year-old health safety net for more than 2-million poor and elderly Floridians, by shifting their care into private managed health care networks.

The measure, which passed 81-34 nearly along party lines, has been pushed by Republicans as a way to save the program from crumbling under its own cost while providing better care to many recipients. Supporters say the number of doctors and services available to recipients in Medicaid has dwindled to the point that the care the system provides isn't very good.

The concept still needs approval from the Senate, which is scheduled to take up a Medicaid measure today that has some significant differences.

Democrats argue that there's nothing that would make private managed care companies cover everything that recipients might need, and worry that benefits will be worse, not better.

Opponents also complain that it isn't clear exactly what the new program will require. State health care officials are negotiating with Washington - which pays more than half the cost of Medicaid - on exactly what Florida will be allowed to do.

Even Republicans have taken a go-slow approach. The version (HB 6003) passed by the House starts with a one-year pilot project in Broward County and a few northeast Florida counties. The Senate version includes a two-year trial period.

In the Senate, Democrats plan to try to put some amendments on the measure, including one aimed at pointing out how many big companies that get tax breaks don't provide health coverage for their employees.

Sen. Walter Campbell, D-Fort Lauderdale, and other Democrats say the biggest reason Medicaid costs are growing is that the number of poor people who can't afford health insurance is growing.

Some of the largest employers in Florida have workers who can't afford health insurance and the Democrats plan to use the Medicaid debate to make that point.

An amendment sponsored by several Senate Democrats would require for-profit corporations in Florida with more than 10,000 employees - such as big retail chains - spend at least 8 percent of payroll on health benefits or give the money to the state for Medicaid. Big nonprofits would have to spend 6 percent on health insurance.

The amendment likely won't pass.

The Senate's Medicaid committee went over several proposed amendments Monday night in advance of the debate and it was clear the Democratic amendment would get a cool reception from the Senate, in which Republicans hold a 26-14 majority.