Florida Gov. Discusses State Medicaid Overhaul Plan
A Florida Medicaid overhaul plan that will begin on a limited basis on July 1 will create a "defined contribution" system under which the state can spend no more than the amount it is allotted for Medicaid, Gov. Jeb Bush (R) said on Friday, CQ HealthBeat reports (Carey, CQ HealthBeat, 1/27).
Bush in December 2005 signed into law legislation that will create a pilot program to shift some of the state's Medicaid beneficiaries to managed care plans and cap spending growth on the program at 8% for the next five years. Under the new system, the state will pay HMOs higher rates for treating sicker beneficiaries than for treating healthy beneficiaries.
Beneficiaries will chose a state-approved managed care plan, with the state automatically enrolling beneficiaries who do not chose a plan. The plan will begin July 1 in Duval and Broward counties. About 210,000 beneficiaries in the two counties will be moved to managed care plans by June 2007. The other changes will take effect after Bush's term ends in January 2007 (California Healthline, 12/20/05).
Speaking at a forum sponsored by the Galen Institute and the Council for Affordable Health Insurance, Bush said his new plan will prevent overspending by the state and give beneficiaries more care options. He added that with proper counseling provided by the state, beneficiaries will be able to choose the best plan for their needs.
However, critics said the plan gives "too much flexibility" to insurers, which will be allowed to determine the amount, services and duration of the services offered, as long as they meet an "actuarial equivalence" test, CQ HealthBeat reports (CQ HealthBeat, 1/27).