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April 23, 2019

As Medicaid Expands Elsewhere, Florida Lawmakers Seek to Shrink it [Tampa Bay Times]

Elizabeth Koh of the Tampa Bay Times writes:

“While the rest of the country talks about or acts on expanding Medicaid coverage, it’s still off the table in Florida. In fact, Florida legislators are moving in the opposite direction.

Both the House and the Senate are expected to agree on at least one issue: extending a policy change that would shorten how long patients can retroactively have bills covered after applying for Medicaid.

The change — which would reduce the state Agency for Health Care Administration’s budget for Medicaid coverage by $104 million, including federal funds — would restrict how long patients can have Medicaid cover their bills to at most the calendar month before their application date. The prior policy allowed patients to have the program cover healthcare costs up to three months before the date they applied for coverage, though the change only affects seniors and those with disabilities. Pregnant women and children are exempted.

Though the Legislature initially voted to shorten the window in 2018, the policy went into effect in February after the federal government approved the change last November. The policy requires the Legislature to approve the change again for it to remain in effect going into July.

The House has moved to shorten that period permanently, while the Senate, in an effort to appease concerned advocates, has advanced measures that would either extend the policy for another year or match the House’s permanent change.

Agency for Health Care Administration officials, including its new leader Mary Mayhew, have cast the change as an incentive for people to sign up for the program sooner.

But advocates, including Anne Swerlick of the Florida Policy Institute [emphasis added], have contended that sentiment ‘ignores the reality of Florida’s Medicaid program.’

Under the new rules, Swerlick told a committee last month, someone who qualifies to be covered by Medicaid on the last day of the month, such as in the case of a catastrophic injury, would only be allowed to have costs retroactively covered for the calendar month in which they apply. If they applied even a day afterward, ‘those thousands of dollars of emergency room bills will not be paid,’ she said. ‘You were unlucky enough to end up in the hospital on the last day of the month.’

‘Ultimately those costs are going to be borne by all of us: higher insurance premiums, higher hospital costs, and of course more uncompensated care costs,’ she added.”

Read more on tampabay.com

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