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From the staff of the Tampa Bay Times

Nelson pushing alternative Medicaid expansion plan for Florida



Sen. Bill Nelson is shopping what he says is way for Medicaid expansion to happen in Florida and avoid concerns that the state would pick up the cost when federal funding is reduced.

He outlined the proposal in a letter today to Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services:

"As a result of your willingness to consider innovative plans, stakeholders in Florida have embraced the challenge and worked to develop a potential solution that would use local dollars to support statewide Medicaid expansion when the full federal financing for the expansion population expires at the beginning of 2017. It is estimated that every day the state of Florida does not expand Medicaid, we lose out on $7 million in federal funding.  And every day we hesitate, this year’s state legislative session draws closer to its close.

"According to initial estimates, the plan would provide coverage to all of the 1.2 million Floridians who fall under 138 percent of poverty – 764,000 of which have no option for affordable coverage at this time.

"Many states use intergovernmental transfers, known as IGTs, to help finance their “state share” of Medicaid expenditures.  Under this proposal, local IGTs would be transferred to the state Medicaid agency, in compliance with federal requirements, to pay for any state cost as it relates to Medicaid expansion after the 100 percent federal financing for the expansion population expires.

"Some elected leaders in Florida who object to Medicaid expansion do so because they believe it could put additional burden on state finances.  This plan eliminates that concern since the cost of health care would be covered through IGTs, thereby removing the state’s fiscal obligation.

"Other objections have focused on a lack of flexibility from CMS.  Your track record of allowing states to adopt delivery models that best suit their unique preferences should alleviate that concern. From Arkansas to Michigan, you and your team have worked to allow states to bring new beneficiaries into Medicaid in a way that didn’t follow the traditional path but delivered the desired result.

"I think you would agree that such a locally financed plan is worth formal consideration and I will continue to work with interested parties to encourage the state to officially offer such a plan."

[Last modified: Wednesday, March 26, 2014 4:33pm]


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