A day after Florida’s House Education Committee voted to send a memorial to Congress seeking fewer strings tied to federal education funding, a health policy panel made the same request for health care funding.
The House Health Innovation Subcommittee on Wednesday approved sending a memorial to Congress asking lawmakers to consider giving Medicaid funding to the states in the form of block grants.
“As you know, Medicaid is supposed to be a partnership. In reality, the federal government is in control,” said state Rep. Frank White, R-Pensacola, who introduced the memorial at the hearing.
“More than at any time in the past, states have the opportunity to have a serious, thoughtful discussion with the federal government about the nature of federal-state partnerships, like Medicaid, and what those successful block grants in Medicaid and other programs might look like,” White said.
White said effective Medicaid block grants would be based on the number of enrollees and adjusted for health risks and income levels. He argued that the states need flexibility to design programs tailored to their specific demographic and geographic needs.
In the public testimony on the memorial, speakers offered a mix of caution and enthusiastic support.
“In the redesign of health care, would you like to be in charge, as the state legislature? Or would you like a bunch of people in Washington to be in charge, dictating terms, creating more requirements, limiting your ability to manage the utilization of your own Medicaid program?” asked U.S. Rep. Matt Gaetz, a freshman Republican who previously represented the Panhandle in the state House.
Gaetz agreed that there were still details to iron out about how the block grants would work, but cited his previous experience as a state legislator and current experience in Congress as he told the subcommittee members that they were best suited to determining Florida’s needs.
“I can say with clear eyes that Washington screws everything up,” he said.
Sal Nuzzo, vice president of policy for the James Madison Institute, voiced his support for motivating Congress to move in the direction of federalism and allowing solutions for state-based health care access.
“The most efficient and effective way to guarantee access to actual care is the method of moving subsidization down to the state level where it can actually intersect with the specific needs of each state’s health population,” Nuzzo told the subcommittee.
Michael Daniels, executive director of the Florida Alliance for Assistive Services and Technology lobbying group, asked the members to proceed with caution, and to continue including the ultimate stakeholders — Florida patients — in the conversation.
Karen Woodall, policy director for the Florida Center for Fiscal and Economic Policy, argued that in the context of block grants, flexibility equaled an erosion of the protections afforded by federal benefit mandates.
Several Democratic lawmakers offered similar concerns.
The subcommittee approved the memorial on an 8-5 vote along party lines.