Title: Florida Center for Medicaid and the Uninsured newsletter
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00091099/00003
 Material Information
Title: Florida Center for Medicaid and the Uninsured newsletter
Series Title: Florida Center for Medicaid and the Uninsured newsletter
Physical Description: Serial
Language: English
Creator: Florida Center for Medicaid and the Uninsured, College of Public Health and Health Professions, University of Florida
Publisher: Florida Center for Medicaid and the Uninsured, College of Public Health and Health Professions, University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: March 2007
 Record Information
Bibliographic ID: UF00091099
Volume ID: VID00003
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.


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March 2007


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Florida Center for Medicaid and the Uninsured

The Florida Center for Medicaid and the Uninsured
Welcomes New Associate Director

As the Florida Center for Medicaid and
the Uninsured begins its seventh year of
research and policy analysis at the
University of Florida, we are happy to
welcome Dr. Bob Cook to our
leadership team. FCMU's management
now includes an executive director, two
associate directors and a scientific
advisory board. In addition to his
position with FCMU, Dr. Cook holds
joint appointments as an Associate
Professor in the Department of
Epidemiology & Biostatistics and the
College of Medicine.
Before he arrived at the University of
Florida, Dr. Cook served as Faculty at
the University
of Pittsburgh,
where he held
appointments in
the Departments
of Medicine and
Behavioral and
Health Sciences
from 1996 to 2006. He received his
M.D. and MPH in Epidemiology at the
University of North Carolina at Chapel
Hill in 1991. After completing residency
training in internal medicine at the
University of Virginia, he completed a
two-year fellowship in the Robert Wood
Johnson Clinical Scholars Program.
As associate director, Dr. Cook will
seek to diversify FCMU's funding
portfolio, possibly to include federal
grants. He is committed to establishing
FCMU's reputation as a premier setting
for research, policy, education and ad-
vocacy related to health care for under-
served Floridians.

Mark your calendar...
State Innovation-
Cost, Quality., & Access
o"' -nnuol f ledicOald
PE.es rch ncd F'olic,
June 28-29 Tallahassee. FL

Florida Medicaid Reform
The Florida legislature granted approval
to implement Medicaid reform on
December 8, 2005. In February of 2006,
the Agency for Health Care
Administration began accepting letters
of intent from health plans interested in
participating in Medicaid Reform in
Broward or Duval Counties.
Administrators of 21 plans expressed
interested, of which 18 submitted
applications. Twelve of these plans were
contracted as of July 1, 2006. As part of
the selection process, the Agency
defined sub-groups of the Medicaid
population and then evaluated each
plan's ability to target the needs of one
of these specific groups.
According to the Medicaid Reform
January 2007 Enrollment Report,
129,073 people are currently enrolled in
reform plans. More than 60% of these
enrollees have chosen or been assigned
to HMOs. The leading plan is an HMO
called HealthEase, operated by
WellCare, a nationwide provider
dedicated to government-sponsored
health plans such as Medicare,
Medicaid, State Children's Health
Insurance Programs and others. The
HealthEase plan offers expanded
benefits such as adult vision and hearing
services and basic adult dental care.

March 2007


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of1 Weqh Status o1n Heat~h'tIl

CareUtiizaion d Cots ", (S
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chidre wit obsiy-elte healt ,, ond.i-

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negotiating volume
discounts with the
drug industry and
issuing discount
prescription drug
cards. He said he will
work with Congress
to foster the safe
importation of drugs
from Canada. The Crist
has proposed insurance

solutions that

include permitting small businesses to
purchase more flexible plan designs and
allowing small groups to join together to
leverage purchasing power. He also
hopes to work at the federal level to
bring funding to states that develop
strategies for the uninsured, and to
garner support for the creation of
interstate purchasing pools.

According to Medicaid Reform's first
quarterly progress report, only one
enrollee had chosen to 'opt-out' of a
Medicaid plan and use the medical
premium to pay the employer portion
for single coverage. The opt-out
program is intended to encourage more
Medicaid enrollees to seek coverage
through their work place. The choice
counselors contracted through Medicaid
reform assist individuals in determining
whether they are eligible for employer-
sponsored care, and whether the opt-out
program is a good fit for their health
care needs. In the first quarter of
implementation, the opt-out call center
received five telephone calls regarding
this program. More recent data is not yet
Enrollment in Medicaid Reform
continues to grow, and a research team
from the University of Florida's College
of Public Health and Health Professions
has actively begun evaluating the
program, as contracted with the Agency
for Health Care Administration.

Governor Crist's Health
Care Agenda
Florida's new governor, Charlie Crist, has
announced four initiatives to keep
Florida healthy. To make health care
more affordable, Crist intends to lower
the cost of prescription drugs by

creation of the
Governor's Com-
mission on Physi-
cal Fitness. Crist
will also promote
intervention and
awareness about
mental health and
create the Gover-

nor's Task Force on Suicide Prevention.
Finally, Crist will try to improve the quality
of care by relying on best practices for the
reduction of hospital-acquired infections,
improved outcomes, and the provision of
more consumer health care information.

1 "Charlie Crist's Prescription To Keep Florida
Healthy:Polcy Overview."

Crist proposes to increase access to
care by strengthening County Health
Department clinics and helping rural
communities develop stronger health
care infrastructures. Increasing the
availability of Home and Community
Based Services (HCBS) and simplifying
the approval process for new health care
facilities would also help heighten
access. Another key element of Crist's
plan to increase access is to attract
students to health care professions
through scholarships and outreach, and
to increase in-state residency programs
for Florida medical students as a way to
retain doctors. A final aspect of the plan
to expand access is the improvement of
Medicaid through eradication of fraud,
ongoing evaluation and expansion of
Medicaid reform, and boosting
enrollment and outreach for Florida's
KidCare program.
To ensure that Florida is a healthy state,
Crist recommends a heightened com-
mitment to prevention. Crist has ap-
pointed Dr. Ana Viamonte Ros as the
Secretary of the Department of Health,
with the added title of Surgeon General.
Crist envisions the State Surgeon Gen-
eral becoming the state's leading voice
on wellness and disease prevention. He
also intends to promote school and
workplace-based obesity and healthy-
eating initiatives. His efforts include the

110Mt env~ns the State
Surgeon GenefoI be-

voice an weltlnes and
disCease prevenion.."

States Take the Lead in
Health Care Reform
A new trend in health policy is
sweeping the United States. A lack of
action on the federal level has led many
state lawmakers to set ambitious
agendas to expand coverage and
decrease rates of uninsurance. A
combination of increased flexibility in
Medicaid spending and design, the
successful implementation of reforms in
other states, and bipartisanship at the
state level have fostered a political
environment favoring increased state-
level innovation in health policy. In
turn, this innovation has the potential to
shape national health policy.
While some states, such as Florida, have
focused on reforming Medicaid, many
others are pursuing comprehensive
health reforms that will apply to the
entire population. Massachusetts and
California have proposed an individual
mandate a requirement that residents
purchase health insurance coupled
with governmental support for those
who cannot afford premiums.
Massachusetts' plan was signed into law
in April of 2006, while California's
proposal awaits approval. The
California proposal is attracting a great
deal of attention due to breadth of the
reform it proposes: the plan will address
an uninsured population that is six times
as large as and much more diverse than
that of Massachusetts.
It is widely believed that the emergence
of these proposals will lead presidential
candidates to place health care reform
high on their agendas during the 2008
election campaigns. Both proposals
have enjoyed bipartisan support and
were introduced by Republican
governors. The apparent consensus over
the need for universal coverage suggests
a significant shift from a decade ago,
when Clinton's health reform proposal
faced opposition from both parties.
In the coming years, many more states
are expected to create innovative plans
to increase access to care at the state

Are HSAs an Option for
Vulnerable Families?
President Bush has said that the United
States government will work toward a
system in which all Americans have
affordable and available health care. By
enacting Health Savings Accounts
(HSAs) under the Medicare Prescription
Drug Improvement and Modernization
Act of 2003, our government intended
to take a step closer to this ideal. HSAs
are high deductible health plans with
very low premiums, designed to
encourage consumers to save health care
dollars in tax-exempt accounts and
make cost-conscious decisions in the
health care market.
Do these plans attract low-income
families that are currently uninsured?
Research suggests they do not.2
Although premiums for HSAs are
approximately 30% lower than standard
plans, deductible costs for these plans
were nearly six times higher than those
of traditional plans. According to the
Department of Treasury, most low
income families do not face high
enough tax liabilities to benefit from
putting money into an HSA plan. It is
also important to consider that almost
30% of the population currently has no
retirement savings and 25% have no
checking account. Moreover, many
people already face significant medical
Although HSAs are an attractive
coverage option for many Americans3
and have potential to reshape the way
we approach health care spending as a
society, many believe that the new plans
do not appeal to the uninsured and
therefore do not offer a meaningful
solution to the problem of uninsurance.

2 Hoffman, Catherine and Jennifer Tolbert. Health
Savings Accounts and High Deductible Health
Plans: Are They An Option for Low-Income
Families? Kaiser Commission on Medicaid and
the Uninsured. October 2006.

3 In 2006, 1.4 million people were enrolled in
HSA-qualified plans offered by their employers,
and at least 855,000 people were covered in the
non-group market.


March 2007

University of Florida
P.O. Box 100227
Gainesville, FL 32610

Florida Center for Medicaid and the Uninsured
Shao!ing Heal rhcar e Policy

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