The top Democrat in the Florida Senate today called for the federal government to reject a proposed overhaul of the state’s Medicaid system, citing public outcry at recent meetings hosted by the Agency for Health Care Administration (aka AHCA).
AHCA held the meetings this month as it prepares for the August deadline to submit its proposal to the Centers for Medicare and Medicaid Services. The plan would shift most of the patients who rely on the program into private managed care plans.
“My Democratic colleagues and I voted against this proposal because there’s no way these companies can provide proper care for people who have serious, chronic health problems and still turn a profit,” state Sen. Nan Rich, D-Weston, said in a statement. “Something will have to give, and unfortunately, we know from experience that these sweeping changes will result in a decrease in the level of care while HMO’s profit.”
Rich’s letter to Health and Human Services Secretary Kathleen Sebelius, as well as her full statement to the press, are below.
TALLAHASSEE – Senate Democratic Leader Nan Rich (D-Weston) on Thursday called on the federal agency that oversees Medicaid to reject a proposal by the Florida Legislature to transfer hundreds of thousands of Florida’s sickest and poorest into managed care, a move Rich says will allow a select group of HMO’s to put the health of their business over the health of Medicaid patients.
“My Democratic colleagues and I voted against this proposal because there’s no way these companies can provide proper care for people who have serious, chronic health problems and still turn a profit,” Rich said. “Something will have to give, and unfortunately, we know from experience that these sweeping changes will result in a decrease in the level of care while HMO’s profit.”
In a letter sent to the Centers for Medicare and Medicaid Services, Rich outlined the growing concerns from Floridians poised to be thrown into the Medicaid managed care system, and those who had been part of a similar, more limited pilot program. As a joint state-federal plan paid mostly by the federal government, Florida’s proposed expansion of the pilot program to the majority of the state’s 3 million Medicaid patients including nursing home residents cannot proceed without CMS’ approval.
“Over and over again, we heard the same thing – HMO’s leaving the county because they couldn’t make a profit and patients unable to see a doctor or get prescriptions,” Rich said. “And now they want to impose this same plan on the rest of the state.”
In urging rejection of the expansion program, the Senator included some of those concerns. In public hearings held by the Agency for Health Care Administration throughout the state, including one in Broward County where the managed care pilot project was launched in 2006, the fears were evident and verifiable.
“The horror stories that Medicaid consumers shared illustrate why the federal government should reject the managed care proposal,” she said.
In Broward County, an elderly woman barely able to walk with a walker, after having multiple spinal surgeries and part of her lung removed, talked about how she had a 20-page notebook of names of orthopedists who would not see her because she’s in managed care. A young man who has been a quadriplegic due to a spinal cord injury from a car accident when he was 16 said he only receives two hours a day of nursing care. In Jacksonville, also part of the pilot program, a three time cancer survivor said she was denied pain medication after discharge following her latest surgery. And in Palm Beach, elder care attorneys warned of ‘granny dumping’ by nursing homes encouraged by financial incentives.
“You can’t listen to these stories and believe for a second that these people will receive the basic care they need in a program controlled by health care executives,” Rich said. “It is unconscionable that the legislature would put the poor and the elderly at their mercy, and there is no way the federal government should sign off on such a plan.”