Florida May Expand Medicaid Pilot Program

Published January 1, 2009

The Florida Agency for Health Care Administration has proposed expanding its pilot Medicaid program, which offers increased consumer choice by allowing Medicaid recipients to pick their health plan from a variety of private insurers, to 20 additional counties.

The program has been hailed as innovative by some analysts, but criticized by others as harmful in luring more people into a taxpayer-funded system.

The call for expansion comes despite the release of a study showing at least 30 percent of participants in the five current test counties don’t understand the options available to them under the program.

Improvement Needed

The pilot program has faced difficulties since its launch in 2005.

According to a study conducted by the Kaiser Family Foundation, Urban Institute, and University of Florida Center for Medicaid and the Underinsured and published in Health Affairs, as many as 30 percent of participants did not know what options were available to them under the program. Many more reported they found the options confusing.

While some people are having trouble understanding their options, it is still a pilot program and can accommodate improvement in some areas, said Dr. R. Paul Duncan, chairman of the Department of Health Services Research, Management, and Policy at the University of Florida.

“The on-paper materials are complex and hard to read, and the enrollees with lower levels of formal education were more likely to have difficulty with the decision,” said Duncan. “However, let’s keep in mind that seven in 10 enrollees went through a complex process that many had never experienced and managed to pick a plan, apparently with relative ease.”

Questioning Study Numbers

Thomas Perrin, director of public affairs at the Florida-based James Madison Institute, noted, “I question the 30 percent number coming from a study done by the Urban Institute, but even if it is correct, this number just shows the amount of people who choose not to partake in the adequate array of policy education options now offered by Florida Medicaid.

“These Florida Medicaid reforms have proven themselves beneficial by increasing competition and reducing cost,” Perrin said. “We are confident they will continue to mature nicely, and will one day be extended to the entire state.”

‘Fundamentally Flawed’

Michael Cannon, director of health policy studies at the Cato Institute, says a confusing array of options is not the program’s primary problem.

“There will be many Medicaid enrollees who cannot navigate the new choices,” Cannon said. “However, that is not the biggest problem with this program.

“Florida’s approach to Medicaid reform is fundamentally flawed,” Cannon continued. “The state wants to give Medicaid enrollees more choices and more control over their coverage. The problem is that those features make Medicaid more attractive and will therefore lure more people into the program, where they are dependent on state and federal taxpayers to fund their health care.”

Aleks Karnick ([email protected]) writes from Indiana.

For more information …

“Florida’s Medicaid Reform: Informed Consumer Choice?” Health Affairs: http://content.healthaffairs.org/cgi/reprint/hlthaff.27.6.w523