This week, the Legislature moved closer to doing…something…about expanding health care to its citizens. Unfortunately, most of it was just wrong.
State Rep. Richard Corcoran unveiled a much-anticipated proposal he dubbed “Florida Health Choices Plus”, which turned out to be severely lacking in health, choice, or any significant plus to Florida’s citizens, taxpayers, or the state budget. The Corcoran plan uses roughly $275 million in state revenue to cover up to 115,000 people. It leaves out childless adults unless they are disabled. The state pays $2000/year per enrollee and requires a $25 per month premium from them, as well as employment work hour criteria.
It is basically similar to Sen. Aaron Bean’s “Florida Health Choices” proposal, which provides coverage for those people under 100% of the federal poverty level with the state paying $10 towards their coverage and the consumer paying a minimum of $20, while making them prove employment or volunteer criteria, as well as periodic evaluations on health assessments.
This is in sharp contrast to simply expanding Medicaid eligibility under the Affordable Care Act. Doing that would mean coverage for 1.2 million hardworking Floridians, would bring $51 billion federal dollars to the state and promote welcome job growth. But who needs that, these legislators are saying, when we could instead send that money to other states and dip into our general revenue to pay for a plan that covers less than ten percent of the people Medicaid would?
Far be it for us to quote Gov. Rick Scott, but when he’s right, he’s right. Scott came out in support of Sen. Joe Negron’s “Healthy Florida” plan, which doesn’t exactly expand Medicaid, but offers a workable compromise that would use the federal funds and cover a million citizens. “The House’s plan will cost Florida taxpayers on top of what they are already taxed under the President’s new healthcare law,” he said in a press statement. “This would be a double-hit to state taxpayers. The [Negron] plan will provide health care services to thousands of uninsured Floridians while the program is 100 percent federally funded.”
For us, an important point to note is that Medicaid expansion helps protect our state’s hospitals. It would contribute an estimated $35 million a year to Jackson coffers and $315 million over nine years. This is to defray some of the cost for care JHS provides that is currently uncompensated (5000 annual inpatient admissions and thousands more outpatient visits).
Medicaid is just one piece of the picture for Jackson. Another big issue is how the Legislature changes the way it reimburses Medicaid payments (they are moving from a per diem method to a per procedure method called DRG). The Senate plan for this shifts $70 million from public hospitals to private hospitals. Jackson stands to lose $46 million with its version of DRG reimbursements. The House plan takes $20 million out of Jackson with DRG, but after increased GME funding is taken into account, Jackson stands to break or even show a small surplus about $125,000 for the next fiscal year. We’re with the House on this one.
There are two terrible ideas working their way through the Legislature, both aimed at undermining public pensions.
HB 7011 would prevent new state employees from entering the pension system, shifting them instead to a 401K-style plan. SB 1392 would require new employees to select the pension plan within five months at a higher contribution rate of 3%. If they don’t within that time frame, they default into the defined contribution (DC) plan. The enticement for them to go into DC is a lower employee contribution rate of 2%.
SB 534 and HB 599 propose to change the valuation method for local and municipal pensions in a way that would hurt the pension funds and essentially is another way to force employees into the 401k-style plans. These bills could have dangerous and costly consequences of artificially inflating liabilities through additional, unnecessary reporting requirements and valuation of pension funds.