First, kudos to Sen. Jason Broduer and Rep. Sam Garrison.
Crafting a superb Medicaid invoice isn’t straightforward, and the lawmakers who handle to do it gained’t see the accomplishment heralded in optimistic TV adverts, unsolicited mail items or endorsements.
However Medicaid laws is necessary. There’s loads at stake for the 5 million Floridians who rely on the federally funded program, and the present system has failed hundreds of them.
Simply have a look at Sunshine Well being. On account of a know-how meltdown, tens of hundreds of well being care claims for the sickest Floridians went unpaid for 3 months.
Sunshine Well being is Florida’s largest Medicaid fee vendor, made even larger final yr when it absorbed Wellcare, the state’s second-largest Medicaid fee vendor. Collectively, they’ve contracts value $31.6 billion with the state’s Company for Well being Care Administration — with cash like that flying round, there’s no excuse for a glitch within the system.
However these contracts are coming to an finish as a result of the plans that supply Medicaid should rebid for a state contract each six years, and the aggressive bidding course of for the subsequent time period shall be printed someday within the subsequent yr.
That is the state’s alternative to repair the system and repair it proper. Merely put, if it isn’t mounted now, it gained’t be till 2028.
In its present, Home-amended kind, the Legislature’s main Medicaid package deal (SB 1950) locations a cap on computerized enrollment, which assigns households at random in the event that they haven’t chosen their plan.
Beneath the present system, huge plans get larger. However below the invoice, plans with 50% or extra of the market share in any area wouldn’t be capable of settle for computerized enrollment shoppers, lest they grow to be too huge to fail.
The invoice additionally strengthens guardrails round negotiations between hospitals and Medicaid plans so that folks can get important well being care providers once they want them. There are some crucial providers that solely a hospital can present, and if a member’s plan is just not coated by that hospital, they could not get care in any respect.
“We’re doing every little thing in our energy to be sure you have the entry to the care you want,” Garrison stated during floor debate (1:05:11) on Tuesday.
Garrison on Monday amended the invoice to permit plans to reinvest income surpluses in workforce growth and profession coaching, somewhat than returning the cash to the state coffers. It’s an idea proponents say will deal with among the main challenges dealing with the well being care system, which has been wracked with employee shortages.
The modification was the product of the committee course of for Garrison’s personal Medicaid invoice (HB 7047), which was honed by way of hours of debate.
He stated the aim is to make sure that Florida does proper by Medicaid recipients, who don’t typically have a voice within the legislative course of, so that all of them has entry to the complete scope of suppliers accessible within the state.
The Home adopted Garrison’s strike-all on Monday and subsequently handed the invoice Tuesday, kicking it again to the Senate.
Now the query is whether or not the Senate will abdomen considerate additions to a invoice it already handed.
Tonight, Sen. Aaron Bean filed an modification to the invoice making clear the Senate is unwilling to satisfy within the center. The Legislature nonetheless has an opportunity to get this proper, however time is working out. With 5 million Floridians relying on Medicaid, there’s loads at stake.
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