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Florida Wins Second Medicaid Waiver

February 19, 2013 - 6:00pm

U.S. Department of Health and Human Services has now approved both of Floridas requested Medicaid waivers which could bring the Sunshine State closer to accepting the expansion of the program as outlined in the Affordable Care Act.

The governors office announced an agreement in principle has been reached on the second waiver, which would grant more Medicaid flexibilities for Florida to coordinate care and help prevent hospital visits.

This is a great win for Florida, and it would not have been possible without the support of legislators who began the fight for this Medicaid flexibility many months ago, Gov. Rick Scott stated in a release.

Improving the coordination of care in Medicaid means we will be able to better manage chronic conditions and give more preventative treatments to help keep Florida families healthy.

The U.S. Supreme Court's ruling last summer on the federal health-care program allowed states to opt out of the laws Medicaid expansion, leaving each state's decision to participate in the hands of the governors and state leaders.

Scott, who has been working with U.S. Health and Human Services Secretary Kathleen Sebelius on the states implementation of the law, already emphatically announced in December that Florida would have an exchange in place by Oct. 1, 2013.

Members of the Senate Select Committee on Patient Protection and Affordable Care Act on Monday reaffirmed that no exchange would be set up this year, but left the option open, leaving other states to test the minefield first.

Sen. Joe Negron, R-Stuart, who chairs the select committee, expected the second waiver ruling to come down this week or next week with his committee expected to vote March 4, the day before the start of the regular session, on how the state should respond to the massive expansion of Medicaids managed care program in Florida.

Earlier this month, the Obama administration approved the first of the two waiver requests from Florida, to move long-term care patients into managed care programs.

With Medicaid eating nearly one-third of the states budget, the second waiver is considerably larger and seen as a key to Florida accepting the expansion of Medicaid.

Getting this waiver approved by HHS, just after our long-term care waiver, makes us two-for-two in our request for Medicaid flexibilities. This helps Florida taxpayers by lowering costs and Florida families by improving health care services, Scott stated.

The agreement in principle to the Agency for Health Care Administration allows the Statewide Medicaid Managed Care program to:

emphasize patient-centered care, personal responsibility and active patient participation;

provide for fully integrated care through alternative delivery models with access to providers and services through a uniform statewide program; and

implement innovations in reimbursement methodologies, plan quality and plan accountability.

Monica Russo, executive vice president of 1199SEIU United Healthcare Workers East, said now that the waiver has been given tentative approval, Scott and the Legislature must accept the Medicaid expansion under the federal health care law.

The federal government has shown that it can work cooperatively with the State to allow flexibility and innovation when it comes to the future of Medicaid by conditionally approving a waiver that moves almost all Medicaid recipients into managed care, Russo stated.

However, the work of reform is not complete, not while more than a million hardworking Florida residents still lack access to quality, affordable healthcare.

We call on Governor Scott and the Legislature to do what is right for our state and expand Medicaid as provided for in the Affordable Care Act, because it will save lives, create jobs and strengthen Floridas economy.

Reach Jim Turner at or at (772) 215-9889.

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