Expanding Access Called Key In Addressing Health Issues

Speakers at a health-care "summit" said Tuesday that expanding access to care for more Floridians could save the state money.

The two-day Florida Health Care Affordability Summit, sponsored by the business group Associated Industries of Florida, included lawmakers and experts addressing topics ranging from controlling drug costs to expanding treatment options through technology.

"I would just encourage you, while you're doing that, to also talk about access --- and access for all individuals," Senate President Andy Gardiner, R-Orlando, said to the audience gathered in Orlando. "It's not just about affordability, and not just about technology --- it's about access."

For instance, Gardiner said, the 2016 Legislature put $10 million into the state's free and charitable clinics because they provide a model that allows uninsured residents to have access to primary and specialty care.

"And that ultimately saves all of us money because they're not coming into our (emergency department)," said Gardiner, who also is a hospital executive. "That is a model that we as conservatives and as business owners should embrace."

Gardiner made a similar argument during the 2015 legislative session, when he led the Senate's push to use money available under the federal Affordable Care Act to offer private health insurance to about 800,000 Floridians. The Senate sought to draw a distinction between its plan and a straight expansion of the Medicaid program.

But the House and Gov. Rick Scott adamantly opposed the plan, arguing that the federal government couldn't be trusted and that Florida could get saddled with the expansion costs in the future. They frequently called Medicaid "a broken system."

While senators have focused heavily on access, the House and Scott have pushed for health-care changes that include reducing or eliminating some longstanding regulations. They contend that such ideas would create more competition and lower health-care costs.

On Tuesday, Gardiner said there were other ways to offer uninsured Floridians a safety net than the Senate insurance plan.

"If the desire in the state of Florida is not to necessarily look at a free-market option for the uninsured --- and that is a debate for another day --- I would encourage you to talk about models like … the free and charitable clinics," he said.

Associated Industries of Florida backed the Senate expansion plan, as did the summit's keynote speaker, Cindy Mann, a former top official at the federal Centers for Medicare & Medicaid Services.

Mann said that while Medicaid has been easy to criticize for political purposes, "that really is outdated thinking. … By 2016, it has become, literally, the largest single health-insurance program in the country."

Mann said states that expanded Medicaid coverage had seen lower private-sector premiums than the states that did not, along with a roughly 30 percent growth in health-care and social-service jobs.

She also indicated Florida should reconsider the terms of a key Medicaid "waiver" that expires next year. She said the state now operates much of its Medicaid program on the waiver, which includes enrolling most Medicaid beneficiaries in managed-care plans.

Speaker Lars Houmann, president and CEO of the Florida Division of Adventist Health System, also pointed to the opportunity to reconfigure the waiver. He said it could take "a very different approach to covering health care for the poor and in fact increasing the availability of health care to that population."

However, Houmann also was critical of Medicaid.

"Our Medicaid program is really not designed to succeed, for the beneficiaries and certainly not for the providers," he said. "I could not put my heart into the term 'expanding Medicaid' when we were talking about the Affordable Care Act. I could put my heart into bringing the money that the Affordable Care Act made available for Florida into expanding coverage for a category of people."

He said he believed the federal government would have approved last year's Senate proposal, "but we couldn't get that done. … But we have another chance now."

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