TALLAHASSEE - With Donald Trump moving into the White House and Republicans controlling Congress, Florida Senate President Joe Negron said Tuesday he wants to start working on a "framework" for how the state could move forward with major changes in the Medicaid program.
Conservatives have long discussed the idea of turning Medicaid into a block-grant program that would give states more flexibility in crafting details of how they provide health care to low-income residents. That discussion has been refueled with last month's election of Trump, who has made Medicaid block grants part of his health-care platform.
Meeting with reporters Tuesday, Negron said he has he talked with Senate Health Policy Chairwoman Dana Young, R-Tampa, and Senate Health and Human Services Appropriations Chairwoman Anitere Flores, R-Miami, about "building a framework for what a block grant program would look like now that there is a reasonable chance that would happen."
"I don't want to want to wait until the federal government acts and Congress acts and then we go into next session and try to build it," Negron, R-Stuart, said. "I'd like to build out the model of what a Florida-run Medicaid system would look like, and then when Washington acts, Florida would be ready to go."
Medicaid, which is funded by the federal and state governments, is a highly complicated program that provides care to about 4 million Florida residents, which children making up more than half of the state's enrollees, according to presentations given this month to lawmakers.
The program is governed by federal laws, with states able to seek approval for what are known as "waivers" to make changes. Perhaps the best example in Florida is a waiver that the state has used in recent years to require most Medicaid beneficiaries to enroll in managed-care plans.
Broadly, a shift to a block-grant program would involve the federal government sending money to states, which would have more freedom to run the programs as they wish. But such a change would be controversial and need approval in Washington, with critics contending that it ultimately would lead to cuts in health-care funding for low-income people.
"A Medicaid block grant would institute deep cuts to federal funding for state Medicaid programs and threaten benefits for tens of millions of low-income families, senior citizens, and people with disabilities," the Washington, D.C.-based Center on Budget and Policy Priorities said in a report posted online Nov. 30. "To compensate for these severe funding cuts, states would likely have no choice but to institute draconian cuts to eligibility, benefits, and provider payments."
But with Florida, like Washington, fully controlled by Republicans for at least the next two years, leaders including Negron and Gov. Rick Scott are touting the idea of moving to a block-grant system - a change that Negron likened to inventing the "system from scratch."
"I think that gives us a lot more flexibility for our Medicaid system and hopefully would, I think, provide an extraordinary opportunity for the House and the Senate to look at ways to perhaps make health insurance available to men and women who get up and go to work every day in Florida but maybe can't pay the full cost of their health insurance," Negron said.