October 20, 2005


U.S. Gives Florida a Sweeping Right to Curb Medicaid (ROBERT PEAR, 10/20/05, NY Times)

The Bush administration approved a sweeping Medicaid plan for Florida on Wednesday that limits spending for many of the 2.2 million beneficiaries there and gives private health plans new freedom to limit benefits.

The Florida program, likely to be a model for many other states, shifts from the traditional Medicaid "defined benefit" plan to a "defined contribution" plan, under which the state sets a ceiling on spending for each recipient. [...]

After meeting here on Wednesday afternoon with Governor Bush, Mr. Leavitt said: "Today will be remembered as a day of transformation for the Florida Medicaid program. Florida's framework will be helpful to other states."

Joan C. Alker, a senior researcher at the Health Policy Institute of Georgetown University, said: "Florida's proposal is one of the most far-reaching and radical proposals we've seen to restructure Medicaid. The federal government and the states now decide which benefits people get. Under the Florida plan, many of those decisions will be made by private health plans, out of public view."

Vernon K. Smith, a former Medicaid director in Michigan who is now a consultant to many states, said: "Florida's program is groundbreaking. Every other state will be watching Florida's experience. South Carolina has developed a similar proposal. Georgia and Kentucky are waiting in the wings." [...]

President Bush has proposed similar changes at the federal level for several years, but Congress has not accepted those ideas. In Congress, Democrats and some moderate Republicans resisted the president's proposals on the ground that they would have allowed states to reduce coverage for very poor and very sick people. On Wednesday, Mr. Leavitt waived many provisions of federal law, letting Florida make the changes in a demonstration project.

Under the waiver, Florida will establish "a maximum per year benefit limit" for each recipient and fundamentally change its role. The state will largely be a buyer rather than a manager of health care.

While Republicans mewl about spending and fail to get many conservative reforms through the Congress they control, the President just keeps revolutionizing the welfare state.

Posted by Orrin Judd at October 20, 2005 8:20 AM

Palm Beach County has its own health care system for the poor. Not a bad system at all. Barely a blip on the property tax radar screen.

Posted by: David at October 20, 2005 10:32 AM

Sounds like a blueprint for a future Vote Jeb! for President commercial.

Posted by: Buttercup at October 20, 2005 10:43 AM

"President Bush has proposed similar changes at the federal level for several years, but Congress has not accepted those ideas."

But I read at NRO that Bush is a "BigSpender", contantly upping entitlements, never vetoing "Spending" Bills.

The very opposite of St. Ronny of Reagan.

Wait, could NRO be wrong?

Posted by: Jim in Chicago at October 20, 2005 11:19 AM

Yes, the president should veto a spending bill created by his party in congress, thus provoking a war between the Republican congressional delegation and the Republican president which would, politically benefit the Democrats.

Oh yes, that would be a politically wise thing to do. (rolls eyes) You know, NRO at times should actually think about the implications - the political implications - of what it suggests and how the president - who is busy trying to make the Republicans the majority party for the next few decades - may have some goals that have absolutely nothing to do with their own short-term ones.

Posted by: Mikey at October 20, 2005 1:38 PM

My new favorite card-palming trick of the anti-Bushniks in the "true conservative" movement is that, when they bring up spending, the metric they use is % increase in spending.

Thus they can say, wow, Reagan slashed spending by "x" %, w/o mentioning that he was following on the heels of the Nixon/Carter/LBJ spendocracy, and then charge that Bush raised it "y" %, w/o noting that we're now in a war, and ignoring his agenda, SocSec reform, the health accts, school vouchers, the attempt to curb medicaid cited here, that in the long-term will reduce federal spending.

Nope, no smoke and mirrors here, Bush is just LBJ in Republican clothing, nothing to see here folks, move along.

Posted by: Jim in Chicago at October 20, 2005 1:49 PM