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Lawmakers debate on Medicaid reform delays

Lawmakers kicked off the House healthcare committee with a heated debate Wednesday over whether the state is adequately prepared to implement state Medicaid reform and the federal Affordable Care Act.

Agency for Health Care Administration Secretary Liz Dudek said Florida is on track to cement the statewide Medicaid reform by 2014---moving the poor and disabled recipients into private managed care plans health plans.

She said Obama's federal health care overhaul, which--if the state complies--could bring thousands of new recipients into the Medicaid program, will be dealt with separately from the statewide reform. 

Florida lawmakers passed a bill in 2011 to expand the five-county Medicaid reform pilot that began under former Gov. Jeb Bush in 2006. Broward, Duval and other panhandle counties continue to operate under the reform, with mixed results.

Supporters argue that the plan will save money for the state and improve care. But many Democrats and patient advocate groups argue that it will be a boon for private insurance companies at the expense of patient care.  Rep. Elaine Schwartz, D-Hollywood, peppered Dudek with tough questions on whether the state has enough staff to make sure health plans don't bilk the state or cherry pick only the healthiest patients. Schwartz said she's particularly concerned about state contracts going to WellCare Health Plans, the Tampa-based company with a checkered past.

"I don't hear from you that there's a beefing up of these programs to oversee the managed care companies," Schwartz said to Dudek. "Are you willing to postpone implementation until you can have proper oversight?"

Duduk responded that AHCA plans to to fill open positions with people who can oversee private managed care programs.

To discourage companies from cherry-picking patients, AHCA will pay health plans higher rates to take on patients with more expensive health problems, she added.

Rep. Gayle Harrell, R-Port St. Lucie, said her biggest concern is that the federal government still hasn't given the green light for the state to move forward with reform. 

"I think we need to move as quickly as possible to make sure a good plan is in place," she said.