Medicaid reform’s huge stakes

Medicaid reform’s huge stakes

Republicans have partisan control of both chambers of the Legislature and a shared intention to move Medicaid patients to managed care plans, yet the state Senate and House of Representatives have significant differences over how to implement those strategies.

Medicaid is expected to cost $22 billion next year (as part of a state budget near $68 billion), a huge sum. The program will cover about 3 million Floridians, so that many lives and more will be affected by the Legislature’s decisions concerning Medicaid.

Despite Medicaid’s notoriously low provider reimbursement rates, many corporate managed care plans and health maintenance organizations see opportunities for expanding market share — thus the substantial private-sector support for moving Medicaid patients to managed care from the traditional fee-for-service payment model.

Medicaid provides insurance for among the following Floridians with low family incomes or few financial assets: children who need basic dental care and medical services; adults with chronic ailments, such as diabetes, that often require hospitalization; people of all ages with developmental disabilities; nursing-home residents with long-term ailments such as dementia.

Funding and providing care to such a wide range of patients are, at best, complex tasks that don’t lend themselves to one-size-fits-all measures.

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