An Encouraging Medicaid Waiver for Florida

Medicaid began in 1965 as a government safety net for poor children and their families. It expanded over the past 47 years to include disabled individuals and patients needing long term care. In 1975, 10 percent of Americans were enrolled in Medicaid. This number increased to 20 percent last year.

Medicaid is funded by a 50/50 match from federal and state governments. Although state governments administer Medicaid, the federal government dictates the rules and regulations that states must follow. Medicaid is now one of the top three budget items for every state in the country. Wanting more control over their own Medicaid programs, states have repeatedly asked Washington, D.C., for waivers from the federal controls.

This week Florida was granted a waiver to allow the state to privatize its long-term care program (here). Florida believes private plans can administer the necessary care in a more efficient, cost effective manner.

Washington state has asked for a reimbursement waiver. Instead of an open-ended federal match, our state would like a block grant, or fixed amount of money, that Washington state could then use as it sees fit. Regulations and controls in Medicaid would come from Olympia and not Washington, D.C.

The waiver ruling for Florida is encouraging. Hopefully the federal government will allow more states broader control of their Medicaid programs.