With clock ticking on Medicaid Managed Care reform, House lawmakers may be drawing a line in the sand

by | Mar 7, 2022

An early Monday morning “strike-all” amendment to a Medicaid managed care reform bill filed by State Representative Sam Garrison sent lawmakers and lobbyists alike scrambling to pull together a deal with just five days remaining in the 2022 Legislative Session.

The bill, SB 1950, was passed unanimously by the Florida Senate just four days ago and then sent to the Florida House for consideration. But the strike-all amendment filed this morning by Garrison is being interpreted by some observers that the House is drawing a line in the sand to prioritize some of the provisions in their own managed care reform bill, HB 7047.

The aim of both bills is to reform the Medicaid managed care system that has been in place since 2013. If a reform deal isn’t struck between the House and the Senate before the close of session expected later this week, about five million Florida families will be stuck in the current system, which critics say is less competitive and offers consumers less choice in the marketplace.

The Senate’s bill places a cap on so-called “automatic enrollment” in Medicaid managed care plans, which is a program that automatically assigns families to specific company’s plan if one isn’t already selected. The bill would prevent larger plans with more than 50 percent of regional market share from participating in the automatic enrollment program, allowing smaller providers to compete.

The bill also requires “essential providers,” like some hospitals, to sign contracts with existing Medicaid managed care plans in each region where they operate, or on a statewide basis, but hospital special interest groups have opposed this measure.

The move on Monday by Garrison to amend the Senate Bill, a so-called “Strike All” amendment, removes all of the Senate’s approved bill and replaces it with 45 pages. It’s a move that signals the House does not intend to adopt the Senate’s version and that the House is unwilling to compromise any further. Garrison’s amendment includes some previous compromises already struck with the Senate, including the 50 percent threshold for automatic enrollment.

The House is also seeking a provision that would allow workforce reinvestment of some provider revenue surpluses, rather then remitting money back to the state, which proponents say would help recruit and train badly needed health care workers.

But with just five days remaining in the legislative session, and with budget negotiations already underway, it’s possible that neither the House nor the Senate will agree to a compromise and that Florida will be stuck without reforms to the program for another six years. By making the amendment move this morning, it appears House leaders may be intentionally telling the Senate that if they want to reform the program, they will need to come around to the House’s version.


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