Florida politics may halt Jeb Bush's Medicaid reforms

Costs are down. Patients appear to be satisfied. Doctors are practicing more preventive care.

Despite these encouraging signs, former Gov. Jeb Bush's "Medicaid Reform" experiment looks like it won't expand statewide beyond Broward County and four Jacksonville-area counties as he had hoped.

The HMO industry doesn't like parts of the plan. Liberals say the program hasn't been properly studied. And Republican legislators are concentrating on solutions of their own to control growing costs of the program.

But not all the ideas behind Medicaid Reform -- such as expanding managed care, providing hospitals more money or trying to provide more patient choice -- are dead.

On Wednesday, the state's reform expert, University of Florida researcher R. Paul Duncan, is scheduled to brief the Senate's Health Regulation Committee to help legislators assess the program as they conduct a top-to-bottom review of Medicaid and the Bush reform.

"Medicaid reform is not the panacea that will solve all of Medicaid's problems," Duncan told The Herald/Times. "But it's also not the train wreck that opponents had envisioned and feared."

Duncan, director of the Florida Center for Medicaid and the Uninsured, has studied the reform plan since Bush pushed it through a reluctant Legislature in 2005. Bush wanted the reform statewide, but the Senate scaled it back to five test counties.

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