Scott unveils budget with Medicaid cuts but awaits word from the feds on waiver

Florida Gov. Rick Scott wants to take a massive bite out of the state's budget by saving money on Medicaid, a health care program for the poor.

"Reforming health care for Medicaid recipients (through a waiver) and state employees to consumer-directed care will lower the cost of health care, increase choice of health plans, and save taxpayers $1.8 billion," Scott said during the 2010 campaign.

Scott and state lawmakers have sought a waiver from the federal government to put more Floridians in private managed-care plans in an effort to save money.

Florida first received a waiver in 2005 for a demonstration project in a few counties including Broward. In 2010 before Scott was elected, the Legislature agreed to seek a three-year extension of the waiver. Scott traveled to Washington on Jan. 31, 2011, to make the case for the expanded waiver.

But that request (as of Dec. 9, 2011) remains pending, said Alper Ozinal, a spokesman with the Centers for Medicare and Medicaid Services. Ozinal said there was no timeline for a decision.

The state is operating under a temporary extension through December 15, according to Shelisha Coleman, a spokeswoman for the Florida Agency for Health Care Administration.

On Dec. 7, Scott unveiled a proposed budget for 2012-13 that would impose new caps on how much the state pays to treat Medicaid patients. Scott suggested using average cost data to set a flat rate for each of 10 types of hospitals.

"No program in this state has grown this fast or costs this much," said Scott, pointing to a chart showing next year"s projected Medicaid costs at $21.6 billion. "If we do nothing, this line will bankrupt our state. We"re going to step up and do something to stop these increases."

Scott proposed setting Medicaid costs at about $19.5 billion -- or about $2.1 billion less than the projection.

Scott can't fully deliver on his promise to reform Medicaid until the federal government responds to his waiver request. And the fate of Scott's budget proposal now lies with the state Legislature.

So for now this promise is still In the Works.