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Fla CHAIN: Medicaid Reform Pilot Expansion May Not Be Healthy for Patients

February 16, 2009

As the Florida Agency for Health Care Administration (ACHA) lobbies to expand the Medicaid Reform Pilot program to include more counties across the state, Wellcare, the program's largest provider, says it will pull out on May 1, leaving about 80,000 people trying to find new coverage. Wellcare is the latest of five companies to drop out of the Medicaid pilot program in the last six months because of cuts in reimbursement rates.

Laura Goodhue, executive director of the health care advocacy group Florida CHAIN (Community Health Action Information Network), says expanding the Medicate Reform Pilot program may not be healthy for patients. It promised to improve patient care while cutting costs, she says, but it has not delivered.

"It's not working, it's not saving taxpayers money, and it's not making Medicaid patients healthier. They need to address the real problems, which are cost containment and a lack of focus on preventative medicine and primary care."

Goodhue says Florida Medicaid rolls are the fastest-growing in the country, with a 10 per cent increase in the past year. She says these patients are choosing from an ever-shrinking pool of insurance companies and doctors who, frustrated by fee cuts, are providing less care.

"You have health plans that are able to limit the scope of the services that people can be provided, and as a result, you have people that don't get proper care, and we've seen some disastrous results from that."

She says help may be on the way with four billion dollars in the federal economic stimulus plan that is earmarked for Florida Medicaid – if legislators do not use that money in the general fund instead.

"We would hope that rates could be restored and the providers would restore services, but we're also hearing that the state government may not use that four billion dollars earmarked for Medicaid on Medicaid consumers."

An ACHA spokesperson says fee cuts were necessary because of statewide budget cuts, but no one will go without services, because the remaining provider companies can pick up the slack.

More information is available at www.floridachain.org

Gina Presson , Public News Service - FL