The first step is done. Now, Florida officials will try to convince the federal government that they should be able to remake the Medicaid system statewide.
The Obama administration this week gave long-awaited approval to Florida's extension of a pilot program that requires most Medicaid beneficiaries in five counties to enroll in managed-care plans. The decision was a victory for Republican leaders who ultimately want to put beneficiaries statewide into HMOs and other types of managed care.
Gov. Rick Scott also claimed at least a small victory this week when the state's unemployment rate continued dropping. But Scott drew criticism when he called for the suspension of Florida A&M President James Ammons amid investigations into the alleged hazing death of a Marching 100 band member.
NOW COMES THE BIG ENCHILADA: State Agency for Health Care Administration officials negotiated for more than a year with the federal government to get approval to extend the Medicaid pilot program through June 2014.
But in the end, approval appeared to be more a matter of when -- not if. That approval came Thursday, with the feds attaching some new restrictions on the pilot to try to ensure quality patient care.
Scott and AHCA Secretary Liz Dudek praised the approval of the extension and said the pilot has been successful. But both also made clear that it is only a step toward overhauling the system statewide, which also likely will take months of negotiations with the federal Centers for Medicare and Medicaid Services.
"Because of these successes, I look forward to implementing Medicaid reform statewide and allowing all of Florida's Medicaid recipients to receive more efficient, higher quality care,'' Scott said.
Republican leaders blame Medicaid for gobbling up large chunks of money that could be used for other things, such as schools. But Democratic lawmakers opposed the move to statewide managed care and have urged federal CMS to reject the proposal.
Meanwhile, the Obama administration wasn't so friendly this week to another health-care request from Florida. The state Office of Insurance Regulation requested phasing in a new requirement that small-group and individual-market health insurers spend 80 percent of the premiums they receive on patient care -- a concept known as a medical loss ratio.
But the U.S. Department of Health and Human Services denied that request Thursday, rebutting OIR's contention that the 80 percent requirement could destabilize the insurance market. Patient advocates say the requirement is needed to make sure enough money goes to medical care instead of getting diverted to insurer overhead and profits.
"We are thrilled to be able to report this huge victory for the hard-working people of Florida, who stand to gain money saved in their health care premiums and peace of mind that their health care dollars are being spent to keep them healthy,'' the advocacy group Florida CHAIN said in a prepared statement.
SCOTT STIRS UP RATTLERS: Florida A&M has been besieged by investigations and bad publicity since band member Robert Champion died Nov. 19 in what police say appears to be a hazing incident.
But after returning from a trip to Israel, Scott injected himself into the issue by calling for FAMU trustees to temporarily suspend Ammons. Like former Gov. Jeb Bush, who was the target of FAMU student protest marches, Scott quickly learned that Rattler nation will strike back if put on the defensive.
FAMU students marched on the governor's mansion Thursday night to send a message that Scott should stay out of the issue. Wearing sweatpants and carrying a bullhorn, Scott went out to talk with the students.
"I would definitely say that he's overstepped his bounds," Marissa West, student senate president, told the Times/Herald Tallahassee bureau. "Our board of trustees is more than capable of making this decision."
Despite the protest, Scott did not backtrack from his position Friday. FAMU's trustees have scheduled a Monday meeting and likely will discuss Scott's suggestion.
JOBS AND MORE JOBS: Scott doesn't use a bullhorn to talk about jobs, but he discusses the issue at almost every opportunity.
New unemployment numbers released Friday gave him a chance to tout his efforts to put people back to work. The unemployment rate dropped to 10 percent in November, down 0.4 percentage points from October.
"We are continuing to move Florida in the right direction by streamlining government, eliminating burdensome regulations, identifying economic-development opportunities and prioritizing education,'' Scott said.
Florida's lower rate matches a national trend. But Scott can point to the fact that Florida's 10 percent rate is the lowest in 30 months, as the state tries to claw back from the recession.
STORY OF THE WEEK: The federal government approved an extension of a controversial Medicaid pilot program that requires most beneficiaries in Broward, Duval, Clay, Baker and Nassau counties to enroll in managed-care plans.
QUOTE OF THE WEEK: "You can take it out of my cold dead fingers.'' -- Sen. Jack Latvala, R-St. Petersburg, after the National Transportation Safety Board urged states to ban cell-phone use while driving.