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Florida Republican Lawmakers Push For Medicaid Block Grants

Kaiser Family Foundation
/
kff.org

Top Florida Republican lawmakers are heading to Washington D.C. soon to discuss potential healthcare changes with their Congressional counterparts. They want President Donald Trump’s administration to blockgrant Medicaid funding. But some Floridians worry the sick and the poor will lose their health insurance.

Florida Senate President Joe Negron says he thinks Washington will likely pass a form of block grants for Medicaid. That could mean the federal government gives states a fixed amount of money and leaves it to them to determine who gets what services.

Negron said it’s a good idea, based on his previous efforts in Florida. He spearheaded the state’s conversion Medicaid managed care.

“I think there’s things we can do that are even revenue neutral to make the system much more like everyone having a health care card under the Medicaid program,” he said.

But those reforms haven’t worked so well for Miami resident Adriana Parrales. The 30-year-old has a rare genetic condition that’s robbed her of her hearing and left her partially paralyzed. She’s currently breathing through a tube. Parrales had to sue the state in federal court to get the care she needs under Florida’s Medicaid program, according to her mom Parrales.

Adrianna was sent home from being hospitalized in early 2015 with no help except for her mother for the next three months. The family settled the lawsuit after the state agreed to more health care workers and new standards.

“This is a kid on a ventilator just came home from a critical unit straight home," Rita Parrales said. "How can I even leave her bedside? And with a Avon lady who just comes in the evenings to help me? So what I had to do was put on some sanitary napkins so that I can at least buy some time not to have to leave her until this lady came to help me out in the evenings.”

The federal government partners with states to provide Medicaid coverage to ultra low-income Floridians. It paid about 60 cents of every Medicaid dollar spent in the state last year.

Senate President Negron said people could lose benefits under a Medicaid block grant program.

“I think the goal would be that the state would be the final arbitrator of what the benefits should be," he said. "My goal wouldn’t be to reduce benefits, it would be to do the same kind of measures that are done in private plans, to have incentives.”

The conversation comes as the Republican-controlled Congress weighs repealing and replacing the Affordable Care Act. Florida is one of a handful of states that did not expand its Medicaid program under the law.

Republican Congressman Matt Gaetz ripped ObamaCare this week inside his townhall while protesters shouted outside. Gaetz said President Barack Obama shouldn’t have let able-bodied people without children get Medicaid.

“I do believe there are people who are on Medicaid today who may not be on Medicaid following the passage of the Republican plan," he said. "We’re trying to provide more consumer choice, more options, give people health savings accounts that creates more agency within the individuals to make more decisions about healthcare.”

President Donald Trump said in January that the Republican replacement of ObamaCare would provide health coverage for everyone. But Gaetz says he didn’t make that promise.

That worries Rita Parrales. She said she’s tired of constantly fighting with her daughter's Medicaid managed care company for more help. The new standards the family fought for may not matter if the state cuts services because the federal government no longer mandates them.

“I ask for a backup ventilator," she said. "It’s not medically necessary. That’s their favorite line to you. Everything is not medically necessary.”

Sarah Mueller is a journalist who has worked for media outlets in several states since 2010. She earned her bachelor’s degree in journalism in 2010 and worked as a print reporter covering local government and politics.