TALLAHASSEE, Fla. (AP) - Sponsors of a massive House plan to
overhaul Florida's Medicaid system on Sunday declared it dead for
this year but said they'll try again in 2011.
The House legislation would have expanded a five-county
experiment in privatized managed care to all 67 Florida counties
over five years. The plan had been one of several sticking points
in budget negotiations between the House and Senate that continued
through the weekend although it would have relatively little effect
on spending in the next fiscal year, which starts July 1.
The Senate proposed a more modest expansion of the pilot to 19
counties but wanted to do it quicker. Leaders of both
Republican-controlled chambers see managed care as a way to cut
costs and fraud in the $19 billion state-federal health care
program that covers more than 2.7 million low-income and disabled
Rep. Dean Cannon, a Winter Park Republican slated to become
House speaker next year, said he didn't believe lawmakers could
resolve their differences during the final week of the 60-day
legislative session that's scheduled to end Friday.
"It looks like major reform isn't going to happen this year,"
Cannon said before a budget meeting. "Hopefully some components of
either the House or Senate plan can be worked out as groundwork to
take it up again next year."
Cannon, who chairs a committee that filed the bill, and Rep.
Denise Grimsley, a Lake Placid Republican who drafted it, said
those components would not include adding more counties to the five
already in the experiment: Broward in South Florida and Duval,
Baker, Clay and Nassau in the Jacksonville area.
Grimsley said one step that's needed this year regardless of
what happens is to apply for an extension of a federal waiver that
Florida received for the pilot program. It's due to expire June 30,
"That keeps us in play," Grimsley said.
The managed-care concept championed by then-Gov. Jeb Bush when
it began in 2006 has strong support among Republican lawmakers, but
is opposed by many Democrats. Also, doctor and patient advocates
say the experiment hasn't gone well.
Physician groups say some doctors have dropped Medicaid patients
because health maintenance organizations have refused to pay for
tests and medications they've prescribed. Patient advocates say
some Medicaid recipients have unknowingly chosen managed care plans
that don't cover drugs or doctor visits they need. It also hasn't
saved as much money as expected.
Senate Ways and Means Committee Chairman JD Alexander, a Lake
Wales Republican who has been in budget negotiations with the
House's appropriations chief, Rep. David Rivera, R-Miami, said
members of Gov. Charlie Crist's staff had expressed reservations
about the House plan.
Cannon, though, said the possibility of a veto did not affect
the decision to pull back. He said the House and Senate plans were
just so different the two sides were unable to come together.
"We haven't even discussed it at all in the Senate," said Sen.
Durrell Peaden, a Crestview Republican who chairs an appropriations
committee that oversees health care spending.
He said he wasn't surprised the House sponsors decided to drop
it this year because lawmakers are focused on several other complex
issues including the budget with just five more days left in the
Although the House began holding hearings Medicaid in October, a
bill was not filed until the session was half over.
Budget negotiators, meanwhile, are continuing talks aimed at
getting the spending plan settled by Tuesday. That's the deadline
to avoid extending the session past its scheduled Friday finish due
to a 72-hour waiting period before a vote can be taken on a budget
that's expected to total more than $67 billion.
Another major unresolved budget issue is a House proposal to cut
state workers' pay by 3 percent. The Senate wants to avoid a pay
Alexander said it may be "bumped" to House Speaker Larry
Cretul, R-Ocala, and Senate President Jeff Atwater, R-North Palm
"Sen. Atwater has strong feelings and, of course, in the Senate
we have a pretty collegial working relationship and (Democratic)
Leader (Al) Lawson has some strong feelings," Alexander said.
Lawson's Tallahassee district includes thousands of state