Thursday, February 22, 2018
Editorials

Federal oversight needed to ensure Florida Medicaid serves those in need

The federal government is more protective of the well-being of Florida's poor than Gov. Rick Scott and the Florida Legislature. Last year, over objections by Democrats and advocates for the poor, the Republican-controlled Legislature voted to turn the state's Medicaid program over to managed care companies. Never mind that persistent problems were experienced in a controversial five-county privatization pilot program and that any cost savings are uncertain at best. It was full steam ahead. That is until last week, when the federal government wisely stepped in to reject at least part of the statewide plan. This is a reminder that federal oversight is important in an era when states such as Florida are more interested in cutting spending than ensuring the poor have access to health care.

Two parts of the state's Medicaid reforms were jettisoned by the Centers for Medicare and Medicaid Services because they would have violated federal law and been excessively burdensome. The state will not be allowed to impose $10 monthly premiums, nor will it be able to charge $100 co-payments for any nonemergency ER visits, charges that were part of the state's attempt to rein in its more than $20 billion Medicaid budget. Imagine an indigent single mother worried about whether to bring her ailing child to the emergency room in case it turns out to be a nonemergency and she doesn't have the cash.

Federal regulators have yet to rule on whether Florida can hand over virtually the entire Medicaid program to private gatekeepers similar to health maintenance organizations. In a two-step process beginning in October 2013, the state wants to limit its Medicaid exposure by paying private companies a fixed price for a certain number of Medicaid beneficiaries, including the frail elderly in nursing homes. The companies would then have the right to approve what doctors patients could see and what procedures they could have done.

As a pilot program over the last five years in Broward, Duval and three rural counties, privatization has had its problems. While proponents point out that a small amount of money was saved, beneficiaries complained that they couldn't get doctors' appointments, and doctors dropped out after being second-guessed. Florida lawmakers pushed for a statewide expansion before it was known whether any money saved was due to efficiencies or because patients were poorly served.

Florida's zeal to cut costs without concern for outcomes is indicative of what would happen if Medicaid were turned into a state block grant program, as has been proposed by Republicans in Congress. It might be fine in states with more enlightened leadership, but it would harmful to the poor in states such as Florida where the bottom line is a bigger priority than providing health care for the poor. Strict federal oversight to ensure that Medicaid is a broad medical safety net is still essential.

Comments
Editorial: They value guns, not kids

Editorial: They value guns, not kids

They value guns over kidsSix days after 17 were killed at Marjory Stoneman Douglas High by a teen-ager firing an AR-15 semi-automatic rifle, the Florida House refused to even debate a bill banning the sale of assault weapons. The vote, 71 to 36, wasn...
Updated: 11 hours ago
Editorial: Listen to Marjory Stoneman Douglas students demanding change

Editorial: Listen to Marjory Stoneman Douglas students demanding change

Students from Marjory Stoneman Douglas High School are traveling to the state capital today and declaring "never again.íí A prominent Florida Republican fundraiser vows he wonít raise another nickel until his party approves new gun controls. Across F...
Published: 02/19/18

Editorial: No more doubt about Russian meddling in election

The latest indictment by the Justice Department special counsel, Robert Mueller, refutes President Donald Trumpís claims that Russian interference in the 2016 election was a Democratic hoax. The indictment details the lengths Russian conspirators too...
Published: 02/19/18

Another voice: Tips should belong to workers, not their bosses

The Trump administration is under fire for proposing a Labor Department regulation that could result in hotel and restaurant employers dipping into the tips customers leave for their employees, depriving the nationís 14 million hard-working restauran...
Published: 02/18/18
Updated: 02/20/18
Editorial: Trumpís rising deficits and misplaced priorities

Editorial: Trumpís rising deficits and misplaced priorities

Itís not popular in Washington or virtually anywhere else these days to express concern about the rising federal deficit. Congressional Republicans who used to be deficit hawks first voted to cut taxes by $1.5 trillion over the next decade, then rais...
Published: 02/17/18
Editorial: Buckhorn should not appeal verdict in firefighterís case

Editorial: Buckhorn should not appeal verdict in firefighterís case

The city of Tampa should have taken Tanja Vidovic seriously from the start when the Tampa firefighter complained about her treatment in the workplace. Now that a jury and judge have spoken, itís time for City Hall to cut its losses, learn from its mi...
Published: 02/15/18
Updated: 02/16/18
Editorial: CareerSource troubles mount as public trust drops

Editorial: CareerSource troubles mount as public trust drops

The dark cloud enveloping Tampa Bayís job placement centers keeps growing. There are accusations of forged documents, evidence of nepotism and concerns about grossly inflated performance numbers that could be tied to receiving more public money and b...
Published: 02/15/18
Updated: 02/16/18
Editorials: Prayers and platitudes after shootings arenít enough

Editorials: Prayers and platitudes after shootings arenít enough

Even before the victims of another mass shooting at another public school were identified, Gov. Rick Scott, Attorney General Pam Bondi, state legislators and members of Congress rushed to South Florida or to social media to offer their thoughts and p...
Published: 02/15/18
Editorial: DCF review should get to the bottom of Hillsborough foster care issues

Editorial: DCF review should get to the bottom of Hillsborough foster care issues

The Florida Department of Children and Families is right to call for a timely and "comprehensive" review of Hillsborough Countyís foster care system. Though the probe is a reaction to a recent case involving a child who was left unattended, the revie...
Published: 02/14/18

A Washington Post editorial: Modernize 911 calling before it becomes an emergency

This Friday marks the 50th anniversary of the first 911 emergency call placed in the United States. Since then, uncounted lives have been saved and people helped. It has been a great accomplishment of government.But even as an estimated 240 million 9...
Published: 02/13/18
Updated: 02/14/18