I am categorically opposed to Governor Bush’s plan to overhaul Medicaid for the state of Florida. Indeed Medicaid, like Social Security, is not something that should be allowed to “wither on the vine,” as has been suggested in the past by key Republicans. In fact, Medicaid provides health care for 40 million Americans nationwide, one in six of our citizens. It serves as the safety net for older Americans needing long-term care, the disabled, and for children living in poverty. It is in fact, often the last resort for millions of poor American families whose wages are so low that they cannot even afford health insurance, essentially serving the uninsured and those that are not insurable because they are either priced out of the private market or pushed out because of their health status.

From my perspective, Governor Bush’s plan to overhaul Medicaid by giving private managed care companies more control of health coverage for nearly 2.3 million poor, elderly and disabled Floridians, is so outrageous that it is being questioned not only by myself and fellow Democrats, but even by top Republicans in the Florida state legislature. This plan, which would make Florida the first state to allow private companies, not the state, to decide the scope and extent of services to the elderly, the disabled and the poor (half of whom are children), is making even Florida House Speaker Allan Bense and Senate president Tom Lee hesitate. Indeed, privatizing and outsourcing government agencies has come under intense criticism in the state of Florida because of multiple scandals and allegations of influence peddling and favoritism. One example of mismanagement occurred last year in the state Department of Children and Families, and another, which involved outsourcing, revolves around the state’s nine year, $350 million contract with Convergys Corporation. Since this company began to work for the state, Convergys has been terribly underperforming in the services it is supposed to be providing, namely work on payroll, benefits and other personnel functions.

Additionally, concerns remain about whether the strategy will only shift health spending from the federal and state governments onto the shoulders of local governments and private hospitals. Many people, including myself, are extremely worried that large numbers of Medicaid patients will reach the spending cap of the Bush program, and then continue to seek health services from doctors and hospitals, who are obligated to treat all patients. Certainly, the state may very well end up kicking hundreds of thousands of poor people out of the program and force them to present themselves somewhere else in the medical system. This in turn will likely place the health care burden on either local government funded indigent health care programs, or on hospitals, which by law are required to treat everyone, regardless of whether or not they have insurance.

Moreover, the Medicaid overhaul program, if enacted, would likely increase the amount of uncompensated care for doctors and hospitals. Certainly, these additional costs would inevitably be shifted to other health care payers in the form of higher premiums, placing even greater financial constraints on employers (especially small businesses), and perhaps even create incentives for employers to leave the market, which would further increase the number of uninsured Americans.

For the aforementioned reasons, I am wholeheartedly opposed to Medicaid privatization, and encourage all legislators in the state of Florida to disapprove of the Governor’s terribly thought out plan.