Protestors carry signs as they demonstrate against proposed cuts to health care programs, including Medicaid. Credit: Justin Sullivan/Getty Images
With state lawmakers wrapping up the 2022-23 state budget, one thing is clear on the health care front: Florida still won’t move to expand Medicaid, despite continued efforts by health advocates and many legislators who want to provide medical care to vulnerable Floridians.
The House and Senate have excluded Medicaid expansion in its budget priorities. And some bills filed in the 2022 legislative session related to expansion haven’t gained any traction.
“The [Florida] Legislature still shows no interest, even getting those bills heard,” Anne Swerlick, senior policy analyst at the Florida Policy Institute, said in a phone conversation with the Florida Phoenix. “They haven’t gotten a committee hearing in years. That’s very disappointing.”
Florida’s Medicaid program is a federal-state effort. In Florida, it’s administered by the state Agency for Health Care Administration (AHCA) and provides health care plans for many low-income residents.
For years, in a Republican-led Florida Legislature, state lawmakers have refused to expand the program that could help address health care disparities and inequities among certain groups.
This year, SB 1504, entitled “an act relating to eligibility for medical assistance and related services,” hasn’t been heard in any committee meeting since it was filed in early January by Democratic state Sen. Annette Taddeo, who represents part of Miami-Dade County.
‘Increased access to care’ through Medicaid expansion
According to the Kaiser Family Foundation, as of March 2022, only 12 states haven’t adopted Medicaid expansion, including Florida. Other states without Medicaid expansion include Alabama, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming.
And 38 states, plus Washington D.C., have adopted Medicaid expansion. Through the Affordable Care Act, known as Obamacare, federal dollars have been provided to states for Medicaid expansion, which extended coverage to adults with incomes up to 138% of the poverty level, according to KFF.
Madeline Guth, policy analyst with KFF’s Program on Medicaid and the Uninsured, said in an email Thursday to the Phoenix that research has found Medicaid expansion through the Affordable Care Act “is linked to broad gains in coverage, increased access to care, improvements in some health outcomes, and economic benefits for states and providers.”
Guth continued: “In particular, recent studies find that expansion has contributed to declines in mortality rates and had positive impacts on populations with cancer, mental health conditions, and substance use disorders.”
The good news
Last year, Florida moved to extend Medicaid coverage for pregnant women and their newborns from two months to a full year, an initiative led by Florida House Speaker Chris Sprowls.
And this year, fortunately, the Florida Senate and House haven’t made cuts to eligibility for Florida’s Medicaid services, said Swerlick of FPI.
“Typically, there are cuts to services or eligibility,” Swerlick said. “And that has not happened this session. The Medicaid budget is actually doing quite well because we are getting substantially more dollars from federal COVID relief. That’s terrific news.”
Meanwhile, some progress has been made through legislation passed in the 2022 session that would require the state to collect and report data on how health care plans under Medicaid are serving residents from different racial and ethnic groups.
SB 1258, entitled, “Managed Care Plan Performance,” is sponsored by state Sen. Shevrin Jones, a Democrat representing parts of Broward and Miami-Dade counties. The bill, in its House version, HB 855, was unanimously approved Wednesday in the Florida Senate and passed earlier in the House. It now heads to Gov. Ron DeSantis for his consideration.
According to a legislative analysis, most Medicaid recipients in the state receive health services through what’s called a Statewide Medicaid Managed Care Program, consisting of different health plans for eligible residents. “We have a very large Medicaid managed care program where most Medicaid beneficiaries in the state are required to enroll in private health insurance plans to get their care,” Swerlick said.
Under the bill, AHCA would be required to report on “performance measure data by recipient age, race, ethnicity, primary language, sex, and disability status” connected to various health care plans under the Medicaid program. The state would measure data on health services, such as prenatal and postpartum care, ambulatory health services, child well-care visits and other measures.
Swerlick said: “Experts agree that to reduce health disparities you have to first know where they exist. Key to this effort is collecting more targeted data on how well the Medicaid health plans are serving certain populations who historically have had difficulties accessing treatment- like people of color and people with disabilities. Passage of HB 855 is an important and laudable first step.”
Jones said in a written statement Wednesday:
“We know that health disparities are a problem in Florida, but without more data from our Medicaid providers, we will never be able to tackle them effectively. I appreciate the bipartisan and unanimous support for this bill — it shows that all of us care about better understanding and addressing health disparities in Florida, and holding Medicaid providers to high standards for all Floridians, no matter your race, ethnicity, preferred language or disability status.”
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