Rick Scott Talks Florida Medicaid

By Gov. Rick Scott

In my family, we seldom saw a physician growing up. My parents struggled financially. My father was a long-distance truck driver, and he was often laid off when department stores were fully stocked. My mother had a hard time finding work that would allow her to also raise five children. When one of my younger brothers had a hip disease, my parents agonized over how they would pay for his treatment. A Shriners Hospital For Children more than 200 miles away came to the rescue. I remember how appreciative my mother was after each visit. I know from experience that parents want their children to have the best health care possible. This means they need access to quality care they can afford.

On Monday, I will meet with Health and Human Services Secretary Kathleen Sebelius in Washington to discuss the health care challenges facing Florida families. I look forward to discussing ideas for addressing the issues of health care cost, quality and access. Reforms like our Statewide Medicaid Managed Care proposal (which is currently with Sebelius for HHS approval along with a proposal for long-term care reforms), tax incentives for individuals to buy insurance, price incentives for healthy behaviors, and flexibility to buy personalized coverage will all lower cost and increase quality in our health care system.

I also look forward to discussing with Secretary Sebelius the potential increase in the number of people in our state's Medicaid program for those who cannot afford health care. While the president's health care law is now the law of the land, the U.S. Supreme Court ruled that increases in the number of Floridians having their health care costs paid for by federal and state taxpayers would be left up to each individual state. There are two key questions driving our consideration of this issue:

• How will we pay for it?

• Will it decrease costs and improve quality and access to health care for Florida families?

Today, Florida's Medicaid program provides health care to more than 3.3 million Floridians. That means that one in six Floridians have their health care coverage provided by tax revenues of the remaining Floridians, and Medicaid is approximately 30 percent of our state budget. The cost of Medicaid has been growing at 3 ½ times the growth rate of the state's general revenue for years. This crowds out our ability to invest in K-12 education, state universities and other priorities.

Growing government is never free. Florida's Agency for Health Care Administration recently reported that adding people to Medicaid under the new law would result in a total cost to Florida taxpayers of more than $63 billion over 10 years. The report also pointed out that the federal government has a long history of dramatically underestimating the cost of government programs.

For example, the Medicaid Disproportionate Share Hospital program was estimated by Congress to cost less than $1 billion in 1992. The actual cost came in at $17 billion. Just as taxpayers pay for our Medicaid program today, they will ultimately be responsible for financing any additional people added into it — however unpredictable that cost may be at this time — for years to come. I am hopeful that Secretary Sebelius and I will have a productive meeting on these important issues.

I remember how my parents struggled to pay for my younger brother's treatment. I believe that having a safety net health care system — like Medicaid — is absolutely critical for those who need it most. But we must understand if we can afford to nearly double (from 3.3 million to 6.1 million by 2022-23) the number of Floridians using Medicaid today under the new law. We must also be certain that nearly doubling the people in this program would improve health care services, not just for those in government-run programs but all Floridians who would be impacted by such a dramatic growth of government in the health care marketplace.

I look forward to a thoughtful discussion with Secretary Sebelius on how we can reform our current system in a way that will keep our economy growing so more Floridians can get a great job (where benefits still provide the best access to great, affordable care), while also improving the quality of health care services Florida patients receive. Our goal must ultimately be to drive down the cost of health care so all families can access the level of care they desire.

Rick Scott is governor of Florida. He wrote this for the Tampa Bay Times.