Gov. Rick Scott on Friday requested a meeting with federal officials about the Affordable Care Act and other health-care issues -- including pressing for approval of the state's effort to enroll almost all Medicaid beneficiaries in managed-care plans.
Scott sent a letter to U.S. Health and Human Services Secretary Kathleen Sebelius that said we "share the same goals when it comes to lowering the costs of health care and addressing the need for better access to quality health care." But while seeking a meeting, Scott also expressed doubts about whether a key part of the Affordable Care Act would meet those goals.
The governor also tied in the state's controversial Medicaid managed-care proposals, which lawmakers approved in 2011 but have yet to receive approval from the federal Centers for Medicare & Medicaid Services, an agency under Sebelius.
"Statewide Medicaid managed care is one way we can act immediately to encourage more competition in health care which would drive down costs and increase outcomes and services,'' he wrote.
Scott sent the letter just days after saying he was willing to negotiate with the federal government about the Affordable Care Act, the health overhaul that President Obama and congressional Democrats passed in 2010. Scott's willingness to negotiate drew headlines, as he had long been an outspoken critic of the federal law dubbed "Obamacare."
The letter also came a day after incoming Senate President Don Gaetz, R-Niceville, and incoming House Speaker Will Weatherford, R-Wesley Chapel, confirmed that the state will not meet a deadline for telling federal officials whether it will operate a health-insurance exchange. The deadline was originally scheduled for Friday, though Sebelius late Thursday extended it to Dec. 14.
Such exchanges, which will begin operating in 2014, are a critical part of the Affordable Care Act because they will serve as online marketplaces for consumers to shop for health insurance. If states don't establish exchanges, the federal government will do it for them.
Scott's letter indicated skepticism that an exchange would meet the goals of lowering health costs and improving health-care access and said Florida needs more information from the federal government.
"Under the current regulatory requirements and the information we have been provided, however, Florida does not have evidence that a PPACA (another acronym for the federal law) exchange can accomplish these goals,'' wrote the Republican governor, who made his fortune in the hospital industry.
But the letter signaled that Scott also wants to discuss other, seemingly unrelated health issues with Sebelius. That includes the Medicaid managed-care proposals, which Florida submitted to the Centers for Medicare & Medicaid Services in August 2011.
The proposals have long been controversial, but it is unclear why federal officials have not made a decision about whether to approve or reject them. Republican backers say moving more Medicaid beneficiaries into managed-care plans would help control costs and coordinate care; opponents argue the move could lead to HMOs squeezing the care provided to low-income people.
Phil Williams, an assistant deputy secretary at the state Agency for Health Care Administration, said during a meeting this week that discussions have been continuing with federal officials about the managed-care proposals. He said he expects the discussions to continue and possibly accelerate.