Christine Jordan Sexton
A contentious plan to overhaul the state’s mammoth health care safety net took its second step forward Monday as a divided House committee approved a bill that will alter the program that currently serves roughly 4 million Floridians.
The House Health Care Appropriations Subcommittee approved HB 7047 by a 10-5 vote along party lines.
If the bill is ultimately approved, it will require the state to enact a long line of changes ahead of Florida’s plans in 2024 to rebid major contracts with managed care companies that now work with the bulk of those who enrolled in the program. There are more than 5 million people in Medicaid but not all are required to be enrolled in managed care. But 4 million are.
Democrats warned about some of the proposed changes included in the legislation that could affect dental services provided to Medicaid as well as affect some of the large public hospitals that treat Medicaid patients.
“We have to ensure we have a health care system that works for everyone,” said Rep. Marie Woodson, a Hollywood Democrat.
Bill sponsor Rep. Sam Garrison, a Fleming Island Republican, insisted that the changes — which have the backing of the Agency for Health Care Administration — would help keep the roughly $35 billion Medicaid program from becoming too expensive in the future.
“It is easy to just say, ‘Keep like it is,’” Garrison said.
The bill does everything from consolidate the number of regions included in Medicaid to requiring that cancer hospitals be included as providers.
But one part that has drawn a lot of attention is a provision to have the managed care plans offer dental services. Legislators several years ago separated out dental services after a fierce legislative and lobbying battle, and the bill would eliminate that “carve out” as it is called.
Joe Anne Hart, chief legislative officer for the Florida Dental Association, said the elimination of separate dental service would lead to unnecessary hurdles for patients seeking dental care.
“It will create a disincentive for dentists to participate,” said Hart, who also pointed out that the state reimburses dentists now at a lower rate than in other states such as California and Texas.
Meanwhile, those representing hospitals said they were concerned about another part of the legislation aimed at requiring so-called essential providers to contract with health plans.
Justin Senior, CEO for the Safety Net Hospital Alliance, called the sanctions contained in the legislation for providers who fail to follow the measure unfair.
“Ultimately we think the punishments need to be less draconian,” Senior told legislators.
The Medicaid managed care overhaul has one more stop before it heads to the full House. A similar bill — but one that preserves the dental “carve out” — is also moving in the Senate. The legislative tug-of-war has attracted plenty of attention as nearly 100 lobbyists have registered to lobby on the House bill.
