Governor Rick Scott has now officially set in motion an ill-advised transformation of Florida’s Medicaid program that will place the health care of most Florida Medicaid beneficiaries into the hands of for-profit companies.  The new law expands a managed care pilot program operating in five counties under a Section 1115 federal waiver. 

In moving ahead with the expansion, Florida’s elected officials ignored many troubling signs highlighted by the pilot project.  Our research has documented many of the concerns about the state’s approach.  Despite these concerns, the Florida Legislature passed a law to expand the pilot project statewide and now the Governor has signed it into law. 

But this law does more – most notably charging a $10 monthly premium to everyone on Medicaid regardless of their income. This change alone, which received no attention as it went through the process, is likely to drive thousands of children off the program if it is approved by federal officials. It’s hard to imagine they will do so.  This one is bad policy as well as bad politics. And Governor Scott’s approval rating is a whopping 29% – the lowest rating for any Governor tracked by the Quinnipiac University poll.

The state must seek a Section 1115 waiver in order for the law to take effect. CMS sent a letter to Florida health officials in April saying the agency will work with the state to approve a waiver but raised concerns about patient care, transparency and accountability under the pilot program. We will be keeping an eye on what happens next.