The Florida House passed two Medicaid reform bills -- HB 7107 and HB 7109 -- on Thursday after a debate of more than two hours. The measures passed on votes that mirrored party lines.

The measures -- which ranked as one of the House leadership’s top priorities for the 2011 session after similar measures stalled in 2010 -- send most Medicaid recipients in the state into managed-care plans, including HMOs. Supporters of the measures pointed to the growing number of Medicaid recipients and warned that these numbers would only increase if nothing is done. The measures also include a liability provision -- limiting potential damages to $300,000, a reduction of $200,000 from the current system, when medical personnel are found liable for injuries to patients on Medicaid.

While the reform measures failed last year, the 2011 versions passed through a number of House committees during the first weeks of the session.

The House agreed on a special format for the debate, with floor managers guiding speakers in blocks during the debate which lasted for more than two hours. Rep. Rob Schenck, R-Spring Hill, the chairman of the Health and Human Services Committee and the sponsor of the measure, led the Republicans, while Rep. Jim Waldman, D-Coconut Creek, served as floor manager for the Democrats.

While Republicans filed technical amendments that sailed through the House, an amendment by Rep. Richard Steinberg, D-Miami Beach, to ensure that Medicaid recipients provide driver's licenses and voter cards to ensure that they are citizens went down on a party lines vote. Schenck argued that the state did not have the constitutional authority to require proof of citizenship.

Rep. Gayle Harrell, R-Port St. Lucie, opened the debate by saying this reform effort resulted from years of grappling with the problem.

“We all know the system is broken,” insisted Harrell, who argued Medicaid was broken in terms of access, finances, quality and accountability. “Patients wind up traveling long distances to receive care.”

Rep. Mia Jones, D-Jacksonville, fired the first shot on the Democratic side, arguing that the Medicaid reform hurt the medically needy and put the state’s financial concerns over patient care. “Our focus is on the dollar, not the patient,” insisted Jones.

Just as they had on Tuesday when Schenck took questions on the bills, Democrats attempted to score points by arguing that Solantic, the medical company that Gov. Rick Scott helped set up before his term in office, would be eligible to receive more Medicaid funds if the reform measures were passed.

“This is a massive shift to for-profit, capitated care that will reduce the scope, amount and duration of care,” said Rep. Mark Pafford, D-West Palm Beach. “We have a governor who transferred Solantic to his wife, the first lady of the state, and apparently the media have found a connection to this bill …”


Speaker Dean Cannon, R-Winter Park, jumped in, ruling that Pafford was moving away from the legislation at hand.

“There are tremendous conflicts of interest in this bill,” continued Pafford, who maintained there would be no accountability or transparency under the measures. “This is a giveaway of $20 billion a year to for-profit, private managed-care companies outside the Sunshine.”

Republicans responded by insisting the reform measures were needed to control spiraling costs. In the 1999/2000 fiscal year, Medicaid costs came to $7.42 billion, almost 18 percent of the state budget. By the 2009/2010 fiscal year, the costs totaled $18.81 billion, more than 28 percent of the budget. Estimates hold that by the 2014/2015 fiscal year, Medicaid will cost $28 billion, more than 33 percent of the state’s budget.