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More Senate 'transparency:' Last-minute Medicaid 'privatization,' vouchers

Three top Senate Republicans have decided to introduce a new piece of legislation -- a last-minute amendment -- regarding Medicaid that was given scant attention after weeks of committee meetings where they talked about the nitty-gritty of health policy.

The amendment directs the Agency for Health Care Administration to ask the feds for a new waiver to Medicaid rules to give the state more power over the Medicaid program, which is largely federally funded and controlled. The amendment would also cap total expenditures of the program, allow Medicaid recipients to use vouchers to buy private insurance, and force some recipients to pay more co-pays and deductibles.

The amendment is offered by fure Senate Presidents Mike Haridopolos and Don Gaetz, along with Sen. Joe Negron. They all sit on the Health Appropriations Committee, but never introduced this idea for consideration before the committee, said Sen. Nan Rich, the ranking Democrat on the committee.

Rich criticized her colleagues for violating the spirit of Senate President Jeff Atwater's push for more transparency in the budget process.

"This privatizes Medicaid," she said. It also could blow up former Gov. Jeb Bush's Medicaid Reform plan, which sought to create more managed-care companies to handle Medicaid without handing the entire program over to HMOs.

Some of the ideas in the amendment aren't new; Medicaid Reform contemplates some vouchers and Gaetz and Haridopolos last year mentioned the block-grant capping of Medicaid and the demand for more "flexibility." But for some reason, it was never submitted as a bill where it could be vetted by legislative and AHCA staff and the committees themselves.