Senate President Joe Negron wants to start preparing for a day when Congress turns the Medicaid system into a block-grant program administered by the states.
“What I’d like to see the Legislature do … is to start building the framework of what a block grant program would look like now that there is a reasonable chance that that could happen,” the Stuart Republican told reporters Tuesday during a briefing in his Capitol office.
“I don’t want to wait until the federal government acts and Congress acts and we go into the next session and try to build it. I would like to fill out the model of what a Florida-run Medicaid would look like, and then — if and when Washington acts — Florida would be ready to go.”
Republican President-Elect Donald Trump has proposed switching Medicaid, which mostly covers low-income people, from an entitlement program largely paid for by the federal government into block grants that would allow states to exercise more control. They could save money by providing care to fewer people.
Negron cast his proposal in more generous terms.
“Rather than treating Medicaid as a program where even the vocabulary that we use is disparaging, in my opinion — we say someone is on Medicaid, as if it’s an addiction; no one says, ‘I’m on health insurance’ — use an ownership adjective,” he said.
“I would like to see a system that empowered our friends and neighbors, millions of them, who get their health care from Medicaid.”
In other words, Medicaid no longer would represent “second-tier medical care,” Negron said.
“That’s what I aspire to. Part of that would come if the state is given the opportunity to build a program that looks like Florida and addresses our issues.”
Such a system also might address the “Medicaid gap” — a problem for people in states, like Florida, that passed on Medicaid expansion under the Affordable Care Act. Many people make too much to qualify for Medicaid but don’t quality for insurance subsidies through that law’s federal insurance exchange.
“I would hope that we would address that,” said Negron, who opposed expanding Medicaid under the ACA, which he would like to see repealed.
“If there’s a block grant program to the state, that opens an opportunity to a new discussion,” he said.
As for the loss of insurance subsidies if Republicans in Congress repeal the ACA, “that’s an issue we would have to address if and when that happens.”