Florida is asking for extraordinary power to revamp its Medicaid program. It’s prompting alarms from health advocacy organizations and policy analysts because it could cut off access to health care for millions of Floridians. They also complain it’s being done without stakeholder input.
Michael Daniels said he been getting a flood of calls from Floridians with disabilities worried they’ll lose their Medicaid coverage. Daniels is head of the Florida Alliance for Assistive Services and Technology program, which is run by the state. He says the calls started right after the presidential election last year.
“I’ve been working with people with disabilities for 32 years and I’ve never seen anything like this," he said. "I get at least five calls a day and I have been getting at least five calls a day since November the 10th of people very concerned. And then it escalated when the term Medicaid block grant was entered into the conversation.”
Last week Florida asked for major changes to its Medicaid program, including waiving federal regulations on medical care access. The shift could mean people lose coverage or access to medical providers. Experts fear it’s a guise for more provider rate cuts and limiting program eligibility. That would mean increases in uncompensated care costs which could lead some doctors and hospitals to close up shop.
Justin Senior, Secretary of the Florida Agency for Health Care Administration wants the federal government to give the state a lump sum for some of its Florida Medicaid funding.
Anne Swerlick is a health policy analyst with the Florida Policy Institute. Swerlick said hospitals already absorbs billions providing health care for free. Governor Rick Scott, who previously ran a for-profit hospital chain, proposed cutting supplemental payments to public hospitals in his budget proposal earlier this year.
“Our current governor, you know, has some issues with some of the safety net hospitals," she said. "He seems to have a preference for the for-profit hospital world.”
Less money would hit hard on hospitals that serve large numbers of uninsured patients. The Safety Net Alliance of Florida declined a request for comment and the Florida Hospital Association responded after the deadline. Mark Pafford, former House Minority Leader and current Florida CHAIN Board member, said providers in the state have a lot to lose if the changes are approved.
“You’re going to see people leave the business, if you will, because that’s what medical care is right now, it’s a business," he said. "And you’re going to see people walk away and I think it’s going to double down on more people without an ability to go to a doctor.”
Swerlick said she’s concerned that the state wants to eliminate retroactive Medicaid coverage that allows people who have a medical crisis get help with medical costs up to three months before they applied for Medicaid. She said removing it will force families into financial debt and insecurity.
Advocates like Swerlick are worried the state isn’t being transparent about what changes it’s seeking. Normally when the state requests program changes, it works with stakeholders and allows for public comments. That hasn’t happened. The Agency for Health Care Administration refused to answer if it will consider public comment. The agency also declined to clarify or answer additional questions about the letter or its intent.
Pafford said rushing through back door decisions without consulting policy experts is not good governing and will hurt Floridians when the next Zika virus or other health crisis hits.
“They’re playing with fire and unfortunately a lot of people are going to get burnt,” he said.