(Stop the presses! This article required sudden rewrite based on breaking news that came in very late day - after this "on solo duty for couple of days" Dad was in midst of picking his kid up from school, shopping, and making dinner. So hey, if you saw the earlier version...uh...fuggedaboutit!)
A flurry of Florida health care reform news today helps clarify much of what happens next in a Sunshine State so clouded by letting more than one in five residents live without the safety net of health insurance coverage.
First, the federal government gave the green light to Governor Rick Scott and the Republican Party of Florida (RPOF) to move forward with forcing most of the state's 3.2 million poor, elderly and disabled Medicaid recipients into managed care programs. That approval has for months now been the thinly veiled "give" being demanded of the U.S. Department of Health & Human Services in order for it to get the state's agreement on moving forward with a large expansion of its Medicaid program, a key element of Obamacare.
The tradeoff does not come without wrinkles and risk. The Medicaid expansion is only being approved for three years, and then must be reauthorized; no small feat in a GOP-dominated legislature like Florida's. And as health care advocates have explained in fighting to improve patient and taxpayer protections in the managed care plan, the concern is that both access to and quality of care for many of the state's most medically needy patients could be compromised by a "profits over patients" mentality of private insurance companies lined up and waiting to take on a flood of newly insured customers.
Some opponents have pointed out that this plan has been championed by a governor who, back when he was just plain old CEO Rick Scott, ran a for-profit health insurance company with just such a bottom line-first approach to patient care, a company so driven by the bottom line that it got busted by the U.S. Justice Department for "systematic fraud" and was slapped with a record-breaking $1.7 billion fine.
So at the very least, this big change warrants close monitoring moving forward, to ensure that our grandparents, disabled relatives or friends and poverty-stricken fellow citizens, all get the consistent, ongoing access to, level and quality of medical care they need and deserve.
The Florida legislature has also now officially announced it will pass on creating a state-run health exchange for roll-out next year, as required by the Affordable Care Act federal health reform law. Instead, legislators will leave it to the federal government to set up and administer the new insurance marketplace intended to help insure many of Florida's 4-plus million uninsured residents.
You might look at that decision and speculate that Governor Scott and the Republican legislators running the state, with a history of fighting federal health reform tooth and nail, are now looking for the feds to put up or shut up; as in, fail miserably and be forced to accept some kind of watered down version of state reform designed by the RPOF, maybe with just a little help from the insurance industry. But, note that today's announcement came with bipartisan support. So who knows, the whole wait-and-see approach may be nothing more than...prudence. Time will tell.
All of which brings us to the best news of all. Rick Scott, the very embodiment of an anti-Obamacare zealot, agreed late today to move forward with a key element of the law, agreeing to expand Medicaid to cover more than a million poor, uninsured Floridians. This comes on the heels of a new report released this morning, finding the state's economy will benefit big time by moving forward with the expansion, including over 70,000 new jobs and nearly $9 billion in new economic activity. The study also found that over $1 billion taxpayer dollars now going to uncompensated care for the uninsured will be saved, along with some of the $3 billion or so that struggling public hospitals lose in providing that care.
When I wrote this column this afternoon, the word from Scott and Republican legislative leaders was was still that their final decision on Medicaid expansion would not not come until Monday, March 4th, the day before the start of the 2013 legislative session. Perhaps they looked over that report (or original version of my article?! LOL) released today, and saw the same thing that the rest of us were seeing; that it's time to start dealing with the crisis of uninsured Floridians, once and for all. May have also remembered that next year is election season once again.
Rarely if ever have I been more pleased to have had to madly rewrite an article, while letting my kid watch a few more minutes of "Toy Story". Okay, shower time.