Florida asks for 7th extension of Medicaid reform waiver

Oct 14, 2011

The following article was published in The Florida Current on October 13,2011:

State asks for 7th extension of Medicaid Reform Waiver

By Christine Jordan Sexton

The Agency for Health Care Administration on Wednesday sent its seventh request to the federal government asking for a temporary waiver extension to continue running its Medicaid reform project in five Florida counties.
At press time the federal government had not approved the request for extension but AHCA spokeswoman Shelisha Coleman said the state was expecting it to be OK’d. If approved, the temporary extension would be good through Oct. 31.
The stumbling block, according to acting Deputy Secretary for Medicaid Justin Senior continues to be the Low Income Pool (LIP), a $1 billion pot of money the federal government provides annually to the state to reimburse health care costs for the poor elderly and disabled.

Florida would like the LIP to remain available through the end of fiscal year 2013-14 although the federal government has said it wants to eliminate all supplemental Medicaid funding Dec. 31, 2013, on the eve of a nationwide expansion of Medicaid, up to 133 percent of the federal poverty level.
 “The state understands that [federal agencies] continue to evaluate the termination of all supplemental funding pools with an end date of December 2013, including Florida’s LIP which would result in a substantial reduction of LIP funding,” the letter notes. “This temporary extension will ensure continued service delivery delivery to Medicaid recipients while the state awaits [the Centers for Medicare and Medicaid Services] decision.”
In addition to establishing the low-income pool, the existing Medicaid 1115 waiver as it is called makes possible a Medicaid reform program in five Florida counties. More importantly, however, it is the linchpin to make possible a statewide mandatory Medicaid managed-care program for most Medicaid patients, from the cradle to the grave.  
Although the waiver is in flux Florida state health planners sent up a series of proposed amendments to the waiver to make possible the new mandatory mandated care program.  
The same day Florida requested a temporary extension of the waiver, the advocacy group known as Florida CHAIN sent a letter to the federal government explaining why the underlying Medicaid 1115 waiver and the proposed amendments shouldn’t be approved.
Like many other groups that have notified the federal government of their opposition to the expansion, CHAIN, which stands for Community Health Action Information Network, argues that the proposal “builds directly on the failed Medicaid reform experiment.”

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