2013 Florida's Health Care Delima

MEDICAID FL - 2013

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Q. Who Joe Negron?

Joe Negron is the senator for Florida’s state senate district 28. He is also a former member of Florida’s House of  Representatives who served from 2000 to 2006.

Q: OK, so what does Negron's plan do?

A: His plan would use Medicaid dollars to extend coverage insurance to roughly 1 million individu­als and families earning up to 138 percent of the fed­eral poverty line, or about $15,000 for an individual and $26,000 for a family of three. Coverage would be contracted through Flori­da Healthy Kids, a state plan that now provides subsidized private care for about 250,000 low-income children.

Q: What type of care would people receive?

A: The proposed plan would have to offer what's called "benchmark" ben­efits, including preventive care such as yearly physi­cals; emergency care; ma­ternity care; and mental-health and substance-abuse treatment. It would not include preventive dental, which Florida Healthy Kids currently re­quires.

Q: Would patients have to pay anything for this?

A: A little bit. Under Negron's plan, patients would have to pay low monthly premiums and co-pays, with the amount set by the Legislature yearly.

Q: Isn't Medicaid free today?

A: That's the big con­cern of health-care advo­cates, who worry that some people can't afford premiums and co-pays.People will be priced out of the health care they need."

Q: Haven't Republi­cans expressed concern that the federal govern­ment won't live up to its promises and support the program in the future?

A: Negron has ac­counted for that. If federal support drops below 90 percent, the program would end.

Q: Are there other al­ternatives out there? What about the House?

A: Senate Chair Aaron Bean, R-Jack­sonville, has put out a com­peting idea, which would try to use state money to help this same population buy basic insurance

Q: What about the 3.3 million people get­ting Medicaid today? Would they switch to private insurers?

A: They will not be a part of this plan. However, pending final approval from the feds, they'll be moved in 2014 into man­aged-care plans run by ei­ther HMOs or doctor-run networks. Those private companies have not yet been selected by the state.

Q: What's the timeline for the expansion?

A: The state must seek federal approval by June 14 and begin signing up pa­tients Oct. L The program must be fully operational by January.

Q: What if Florida is not ready by January?

A: There's no hard deadline. Once a plan is approved, Florida can col­lect the federal money from that point on. If, say, expansion begins in July 2014, Uncle Sam will pay the full cost from then through 2016.