Rationale
Florida was one of the last states that adopted Medicaid. The state did it as late as in 1970, in comparison with many other states that did it in 1966 (Norris, 2017). The latest reform of the program was initiated in 2013. The rationale for the program is to make healthcare easier to access for the underserved categories of the population such as children, the elderly, disabled, and others who are eligible for the option and cannot afford the insurance.
Adoption of the Reform
Between 1980 and 2004, the expenditures of Florida on Medicaid increased by 13.5% annually, which was a threatening trend. In order to eliminate the negative outcomes of such a situation, the state of Florida applied for the 1115 waiver for the pilot project of the Medicaid reform (Norris, 2017). The pilot was approved, and it reached beneficial outcomes in two counties in 2006 that was joined by three other counties in 2007. Over the past decade, the waiver was enhanced several times (Norris, 2017).
In 2013, an amendment for the expansion of managed care was approved by the federal government (Norris, 2017). The amendment changed the name Medicaid reform into Managed Medical Assistance. At the moment, over 75% of Florida’s Medicaid beneficiaries are engaged in managed care plans (Norris, 2017).
Waivers of Florida’s Medicaid Program
The State of Florida has several waivers incorporating the following elements:
- project AIDS care;
- iBudget Florida;
- developmental disabilities individual budgeting;
- inherited dysautonomia waiver;
- model waiver (“Florida Medicaid waiver,” n.d.).
These waivers are developed to support people with needs who do not have proper access to health care. The model waiver gives assistance to eligible children younger than 21 years old who suffer from the degenerative spinocerebellar disease (“Model waiver,” 2017). iBudget waiver’s purpose is to arrange appropriate community-based and home support to eligible individuals with developmental problems and encourage self-determination (“Developmental disabilities,” 2017). iBudget Florida waiver suggests such options as dietitian and dental services, occupational, respiratory, and physical therapy, supported employment and living coaching, consumable and durable medical supplies, and others (“Developmental disabilities,” 2017).
Another group of waivers of Florida’s Medicaid program is focused on eligible elderly persons:
- facilitated living for the elderly;
- carrying about the frail elderly;
- support for aged and disabled adults;
- Alzheimer’s disease program (“Florida Medicaid waiver,” n.d.).
These waivers are aimed at supporting and assisting elderly citizens who cannot provide the necessary facilities by themselves.
Funding Structure
In the 2007-2007 fiscal year, the state of Florida spent nearly $14 billion on Medicaid (Harman, Lemak, Al-Amin, Hall, & Duncan, 2011). In the 2008-2009 fiscal year, the number rose to $15 billion (Harman et al., 2011). The development of Medicaid is a rather promising opportunity for the states since it can help to govern costs by guaranteeing proper utilization of health care (Harman et al., 2011). According to Chester (2015), there is much controversy concerning the budgeting of Florida’s Medicare program. The program is governed by the federal government and the state, the former covering the greater part of Medicaid expenses in all states.
The budget of the state of Florida is $74 billion. 65% of this sum ($48 billion) is provided by the state funds, and 35% ($25 billion) is provided by the federal funds (Chester, 2015). In 2014, the total amount of money spent on Florida’s Medicaid equaled $23 billion. According to such statistics, Florida’s contribution to the Medicaid program is 9.5$ billion, which makes 20% of the state’s budget (Chester, 2015). In comparison with other programs, Medicaid’s budget is much smaller: 23% is spent on elementary and secondary education, and 13% is spent on higher education. Moreover, out of the 23$ billion given to Medicaid in 2014, the greater part came from federal funds: 59% versus 41% provided by the state treasury (Chester, 2015).
As Chester (2015) mentions, the state of Florida, along with many other states, exaggerate their financial role in Medicaid. While they claim that the program undermines their budgets, the majority of the states, in fact, contribute to Medicaid no more than 15% of their funds. Such a situation is possible due to the fact that the greater part of funding across Medicaid programs is provided by the Federal Medical Assistance Percentage (FMAP) (Chester, 2015). The FMAP has different distribution across the states, but Florida was lucky to receive as much as 59% FMAP in 2014 in general, along with other FMAPs for special purposes. As a result, every $1 spent on Medicaid by Florida state corresponds to $1.43 given by the government. As a result, Florida benefits from the Medicaid program, and there are positive changes in this direction. According to research, the expansion of Medicaid may reinforce the state’s economic activity by $8.9 billion and provide 71,300 job openings (Chester, 2015).
Impacts
The greatest positive outcomes of Florida’s Medicaid program are concerned with the possibility of uninsured citizens to receive quality healthcare (“Florida’s Medicaid reform,” 2011). Three major goals of the program are the continuous improvement of people’s health, increased patient satisfaction, and decreased the cost of healthcare services (“Florida’s Medicaid reform,” 2011). Due to this reform, many people belonging to different underserved groups have gained the possibility to obtain high-quality care despite the fact that they cannot afford the insurance.
References
Chester, A. (2015). Florida’s Medicaid budget: Just the facts. Center for Children & Families (CCF) of the Georgetown University Health Policy Institute. Web.
Developmental disabilities individual budgeting (iBudget) waiver. (2017). Web.
Florida Medicaid waiver. (n.d.). Web.
Florida’s Medicaid reform shows the way to improve health, increase satisfaction, and control costs. (2011). The Heritage Foundation. Web.
Harman, J. S., Lemak, C. H., Al-Amin, M., Hall, A. G., & Duncan, R. P. (2011). Changes in per member per month expenditures after implementation of Florida’s Medicaid reform demonstration. Health Services Research, 46(3), 787-804.
Model waiver. (2017). Web.
Norris, L. (2017). Florida and the ACA’s Medicaid expansion. HealthInsurance. Web.