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Premiums may force 800,000 from Medicaid: report

About 800,000 people may be forced out of the state's Medicaid program if they must pay the $10 per month premium proposed by the Florida Legislature last spring, according to areport released today.

More than 660,000 of those who lose coverage are likely to be children, says the study, a part of a series from Georgetown University and the Jessie Ball duPont Fund. (Disclosure: The Jessie Ball duPont Fund is an underwriter of Health News Florida.)

The change could cut nearly in half the number of Floridians enrolled in Medicaid, the state’s health insurance for the poor and disabled, said Joan Alker, a co-author of the report.

Children will bear the brunt of the losses, largely because there are far more children than adults enrolled in Florida’s Medicaid program, Alker said.

“If (other) states do have premiums for children, it's at higher income levels. There's nothing else as broad as this in the entire country,” she said.

Researchers analyzed experiences from other states that charge premiums and used a formula to determine how many people are likely to lose coverage, Alker said.

A one-parent, two-child family that earns $11,000 per year would pay about $360 per year in premiums, or 3 percent of their incomes, the report states.

Nursing home patients would be exempt from payment, the report says.

The premiums are part of a larger Medicaid reform package that would move nearly all of Florida’s Medicaid recipients into managed care plans. The reform and the premiums are both pending approval from the federal government, which pays more than half of the cost of the Medicaid program.

A pilot version of the reform has reaped controversial results in Broward, Duval and three rural counties. A University of Florida study found that privatizing Medicaid may save some money. Critics contend that any savings came at the expense of needed care.

The latest to weigh in, a conservative Naples group called the Foundation for Government Accountability, said in a recent report that the pilot not only saved money but raised patient health outcomes and satisfaction rates.

Lawmakers hope that the overhaul will help plug millions in the state budget, but the motivation for the premium charge appears to be more “philosophical,” the Georgetown report says.

Rep. Matt Hudson (R-Naples), chairman of the Florida House Appropriations Sub-committee, argued for the proposal on the House floor, saying the change would make people “personally responsible for their own health.”

"Everyone else in society is paying a portion of their own health care, including the military and retirees,” he said. “So why shouldn’t this segment of the population?”

Hudson declined to comment for this article.

Rep. Elaine Schwartz (D-Hollywood), a vocal opponent of the overhaul, said she doesn’t believe people should treat state-run services like the private sector.

“It's totally unrealistic that these people could pay this premium, it's punishing...I can't comprehend it,” she said.

Laura Goodhue, of health-advocacy group Florida CHAIN, said she frequently sees people for whom the premium would be an impossible reach.

“There are so many things that could prevent people from paying,” she said. “Are they homeless? Do they have a bank account? It’s a huge barrier, even if you don’t look at affordability.”

---Health News Florida is an independent online publication dedicated to public-service journalism. Reporter Brittany Alana Davis can be reached at 954-239-8968 or by e-mail.