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Medicaid Block Grants Could Cut Health Care Access For Some Floridians

Florida Capitol Building in Tallahassee

Florida Capitol Building in Tallahassee. Source: WikiMedia Commons

In 2011, the Florida legislature passed a measure to convert Medicaid insurance into a managed care system. But Republican lawmakers now want to take the program away from what they call “big businesses” and change it into a block grant system. But Medicaid providers say if that happens, low-income families will lose access to health care.

A lot of lobbying goes on at Florida’s Capitol. But it’s hard to miss former basketball star Erving “Magic” Johnson hoofing it from office to office.

The six-foot-nine athlete is a minority stakeholder in Simply Healthcare, a Medicaid managed care company based in Miami. It’s looking to get its contract renewed with the state.

Here’s part of Johnson’s pitch to Senate President Joe Negron: “It was important that we got into the community. And I think that’s what sets us apart from everybody else, you know. Getting into the community, having those community town hall meetings, making sure we talk to the whole community. Even if you weren’t one of our patients…we were still talking to the community.”

Florida lawmakers are making similar arguments for block grants that they made six years ago for managed care.

For the first time since 2001, Republicans control the White House and both houses of Congress. Republican state lawmakers, including Governor Rick Scott, are asking Congress to block-grant Medicaid money to them as Congress weigh changes to federal health policy.

House Speaker Richard Corcoran says block grants are the solution. He says Florida could expand health care access by giving Medicaid recipients a fixed amount of money to buy coverage on the open market.

Corcoran says it would provide “tremendous access for those working poor to get a health insurance product or a health product to help them with their health care needs that right now they currently can’t get under the current system.”

But just a few years ago he was calling managed care the solution. In 2011, Corcoran said, “The reason I’m supporting this bill more than any other reason is the quality measures. The quality of care will be better.”

Enrollment continues to increase and so has the price tag. Medicaid Managed Care didn’t produce the savings Florida Republicans promised it would. But a block grant could mean Florida gets less money from the program than it does today.

For Melanie Sellers, the idea of cuts is frightening. She directs maternity services at rural Jackson Hospital in Mariana. She said most of the pregnant women served by the hospital are covered by Medicaid.

“So much stuff is caught early on and treated, said Sellers. “If they are not able to receive the prenatal care, then we would see more morbidly and mortality among the mom and unborn child, and then as a child.”

Right now, the federal government picks up 60 percent of Medicaid costs in the state. Restricting more federal dollars means the state has to increase its own program costs or cut benefits. That likely means slashing the number of people getting services or the number of services.

Senate President Joe Negron, who now supports block grants, was a chief architect of the managed care system. But he acknowledges that under block grants, cuts are possible.

“My goal wouldn’t be to reduce benefits,” says Negron, “It would be to do the same kind of measures that are done in private plans, to have incentives.”

Yet according to the Florida Hospital Association, Florida is dead last in Medicaid spending for children.

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