Consumer health care advocate decries proposed Medicaid changes listen06/15/11 Kate Bradshaw
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As you just heard, this week, Florida’s Agency for Health Care Administration is holding hearings throughout the state to get public input on sweeping changes to the state’s Medicaid program. Hearings have attracted hundreds in places like Jacksonville and Palm Beach, and there was reportedly a standing room only crowd at one in Largo today. Ahead of tomorrow’s Tampa hearing, we spoke with Laura Goodhue, Executive Director of Florida Community Health Action Information Network, or CHAIN. She said the meetings are drawing big crowds for a good reason.
"People are just upset. They don't think that this makes sense. They don't want to put vulnerable Floridians, seniors, disabled, and kids, into plans that may alter the services they get. They're really, really concerned about HMOs putting profits over patients. That's what we've seen. We've already had an experiment with this, as I mentioned, in these counties. It just hasn't shown to increase the quality of care, help people out at all, or save the state money. The big question is, 'Why is Florida taking this big risk and this big gamble for Florida's most vulnerable citizens when we don't have any proof that it works?' This is really drastic changes and we're not just talking about putting people in HMOs because lots of people have HMOs. The way they want to do this is really HMO on steroids. They're given so much power to alter the way that Medicaid works that we've seen that this results in delays and denials of care and that's what we're really concerned about."
You've called it a failed experiment in the five Florida counties that are currently affected, why do you call it a failed experiment?
"We've had 5 years of this and we've seen just so many problems that have been documented, not only by my advocacy group, Florida CHAIN but also external reviewers like the Georgetown Health Policy Institute, the state's own acccounting arm, '...'. Independent evaluations have shown that it has not lived up to the promises of increasing the value of Medicaid, of expanding access to care, and there's no data that says it saves the state money which really the bottom line is the state is trying to cut costs here. We have no proof that it's doing that. In fact, it seems that a lot of extra costs are going into the community to help people just navigate these services and pick up the pieces. We're spending more money in the counties that are affected just doing that and struggling to get people their needed medications and hospital stays and home therapy. We have a lot of anecdotal evidence of people who have just not been able to get access to care. There was a patient in Jacksonville who died because she didn't get a kidney or a liver transplant in time and she was under the Medicaid reform plan. Lots of other people that just have really had it with the red tape in these plans."
You had said that essentially it doesn't save money as much as displace the cost. In what ways does this happen? And who's responsible, ultimately, for these displaced costs?
"It's up to the safety net system in our communities. If there's a senior who is mistakenly enrolled in a plan and they're in Medicare and Medicaid and they can't get access to their medications it's up to whoever is helping in that community and those people kind of survive and they make do. These are very low-income Floridians. They don't have access to a lot of help. Mental health patients in clinics who cannot get their medications or they're denied certain services. They might end up....we have stories, documented stories, people end up going to the ER because they're suicidal because the drug that was working for them and had stabilized them is no longer on their plan's list of authorized drugs, they're making them take another one, a cheaper one instead, see if that works. So there's real costs being born out on our communities."
"The other thing that I think is important to note is that the state is trying to save money and it's obvious we have a huge budget deficit that they closed last session, but they also put in the state budget $2 million to hire a state lobbyist to push this through Washington, to push this waiver application. So we're talking about cutting money and turning back money from the Affordable Care Act, it seems kind of ridiculous that the state would spend $2 million on a lobbyist to push this through. That's why it's even more important that the people that are turning out for these hearings are also appealing to the federal agencies. That they're writing to see a "..." in Baltimore, the center for Medicare and Medicaid services. There's certainly going to be a lot of pressure from the state of Florida to push this through and we just need to fight back that much harder."
Critics of the plan also say it would incentivize carriers who drop nursing home coverage for seniors on their plan. State Senator Joe Negron helped draft the bill that effectively privatizes Medicaid. His office did not request a call for comment by airtime. Tomorrow’s Tampa hearing takes place from 9am to noon tomorrow at the Florida Department of Transportation Auditorium, at 11201 North McKinley Drv. In Tampa.