Scott goes to Washington looking for Medicaid waiver

Florida lawmakers, including Gov. Rick Scott, believe one of the ways to shrink the state budget is to expand privatization of the state-administered Medicaid system. But before they can do it, the federal government needs to sign off on the idea.

During the campaign, Scott pledged that if he could get the federal government's okay, he could slash $1.8 billion from the state budget. To put that in perspective, that is about half of the projected budget shortfall for 2011-2012.

"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.

Florida's Medicaid program -- which provides health care to low-income individuals and families -- costs $20.2 billion for fiscal year 2010-11 with the state and federal government sharing about equally in the cost. But the cost is going up -- bad news as state revenues are shrinking. The Medicaid program is expected to climb to $25.08 billion by 2013-14. For some perspective, the entire state budget in 2010-11 was about $70.4 billion.

Scott and lawmakers believe they can save money by receiving a waiver from the federal government to put more people in private managed-care programs. Critics, meanwhile, worry for-profit providers will cut corners when it comes to patient care and deny medical services to increase profits.

On Jan. 31, 2011, Scott was in Washington, D.C., to meet with Health and Human Services Secretary Kathleen Sebelius to ask for expedited approval of a Medicaid waiver, the St. Petersburg Times reported. "Both had an open mind and listened to each others' concerns," Scott spokesman Brian Burgess said.

But the Associated Press reported that the federal Centers for Medicare and Medicaid Services likely won't make its decision on a waiver until June, after the Legislature's March 2 to May 6 session ends.

"This has been a controversial waiver with so many issues expressed by advocates about access and quality of services," spokeswoman Mary Kahn said. "We'd have to take a very, very close look to make sure those concerns can be addressed and make sure that Medicaid beneficiaries can best be served by extending the waiver."

Scott clearly has made his move. Now he waits for the federal government's response. For now, that means this promise is In the Works.