Gov. Scott's agency revises flawed Medicaid expansion study

What a difference a day and a few assumptions make.

On Tuesday, Gov. Rick Scott's office defended a questionable Dec. 17 report that Florida taxpayers would be on the hook for nearly $26 billion over 10 years to expand Medicaid as part of President Barack Obama's health care plan.

Late Wednesday, Scott's Agency for Health Care Administration released a revised estimate.

The new 10-year cost?

$3 billion.

Why the enormous difference? The new estimate includes the federal matching funds promised in the health care law to pay for the Medicaid expansion. It also exlcudes costs associated with people who are now eligible for Medicaid but for one reason or another have not enrolled. The revised estimate is more in line with costs estimated by outside groups, and could soften attacks that the expansion is too costly for Florida to afford. With some other changes, the estimate climbs to about $5 billion.

Scott had used the eye-popping $26 billion estimate to make a case against the health care law both on Sunday in a Tampa Bay Times editorial and again on Monday following a meeting with Health and Human Services Secretary Kathleen Sebelius.

But the dollar-figure was quickly debunked as based on severely suspect assumptions and was panned by Democrats, health care advocates and even a prominent Republican lawmaker.

On Wednesday, House Appropriations Chairman Rep. Seth McKeel, R-Lakeland, released a subtle but unmistakable jab at the original veracity of the estimate.

While "it is important to recognize the potential state financial exposure should the federal laws change for the worse," McKeel wrote, "we must follow our process which requires estimates based on current law and practice. This is critical to the integrity of our budgeting process."

Scott's office had defended the original $26 billion estimate Tuesday, arguing that while the federal health care law promised additional Medicaid funding, it might not actually come.

The plan to expand Medicaid, the government-run health insurance program for the poor, is a key but optional part of Obama's health care law.

States, which manage the proram, can decide whether to expand the program or not, but to make the option enticing, the federal government offered to pick up most of the costs to cover more people.

While the federal government is paying about 58 percent of the costs for current Medicaid recipients, it has agreed to pay 100 percent of the costs for newly eligible Medicaid recipients from 2014-16. The federal government would cover 95 percent of the costs in 2017, 94 percent of the costs in 2018, 93 percent of the costs in 2019 and 90 percent of the costs in 2020 and beyond.

Insurance companies, doctors prepare for another battle over drug dispensing

In Florida, patients on workers compensation can receive their prescription medications directly from a doctor instead of going to a pharmacy. On the surface, this might not sound like a huge deal, but the ongoing dispute surrounding this topic is gearing up to be one of the most costly battles of the 2013 legislative session.

On one side are insurance companies and businesses. They say doctors who dispense drugs, and the drug repackaging companies who able to sell medications at marked-up prices, drive up the cost of workers compensation insurance and make doing business in Florida more expensive.

On the other side is Automated HealthCare Solutions, a private company that sells physicians software needed to dispense drugs, the Florida Medical Association and doctors who say that their ability to provide patients with prescription medications at the office improves quality of care and gets people better faster.

In 2011, the Legislature passed a bill that would have reigned in drug repackaging costs, but then Gov. Charlie Crist vetoed it. Last year, passage of similar legislation seemed imminent but some behind-the-scenes infighting among Republican senators put the skids on the efforts and Automated HealthCare Solutions seemed to have won again.

Sen. Alan Hays, R-Umatilla, has vowed to sponsor legislation again this year and says he is confident that the drug repackaging issue can be resolved.

Both sides will likely spend millions hiring lobbyists and experts in hopes of influencing the debate, and the main players also dole out campaign contributions during election season.

Study: Oil and dispersant from Deepwater Horizon were toxic to Florida reefs

From the Tampa Bay Times Craig Pittman: 

Oil from the 2010 Deepwater Horizon disaster would have killed coral reefs in the Florida Keys if the plume had reached that far south, especially when mixed with the dispersant Corexit 9500, according to new study published Wednesday.

"Dispersant and oil combined is worse than the oil alone," said Kim Ritchie, a senior scientist at Mote Marine Laboratory in Sarasota who is one of the authors of the paper.

The oil and dispersant from Deepwater Horizon likely damaged or killed coral reefs in the Gulf of Mexico, Ritchie said, but no one has reported any studies on that aspect of the disaster. At one point about a month after the spill began, the plume of oil floated over the western edge of a roughly 61-mile expanse of 300-to-500-foot-deep reef south of Louisiana known as the Pinnacles.

Coral reefs provide shelter, breeding grounds, and nursery habitat for a variety of fish and other creatures. They are made up of corals, living organisms that work with other corals to create underwater ridges. More here. 

 

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Hospitals that serve Florida's neediest patients concerned about proposed change to Medicaid payments

Hospitals that serve Florida's neediest patients stand to lose the most under a new system for how the state doles out Medicaid dollars.

The DRG payment model — or "diagnosis-related group" — would categorize Medicaid patients based on the type and severity of illness and pay hospitals accordingly. Currently, hospitals are paid various daily rates based on actual costs.

Dozens of hospitals stand to receive more Medicaid dollars under DRG, but representatives of the state's 15 "safety net" hospitals say their facilities are among the biggest losers. That includes Tampa General Hospital and Miami's Jackson Memorial Hospital.

Advocates say the model should be tweaked so that these hospitals, which serve the state's poorest and most severely injured patients and are often the training ground for future doctors, are held harmless.

The state Agency for Health Care Administration has run the numbers showing what each hospital could receive under DRG compared to the status quo in the 2013-2014 fiscal year.

Jackson Memorial would drop from $345.6 million to $301.2 million. Tampa General Hospital's payment would decrease from $139.5 million to $128.2 million.

Even though the model was tweaked in a way that benefits the state's two freestanding children's hospitals, All Children's in St. Petersburg and Miami Children's would lose $9 million and $1.4 million respectively.

None of the 13 hospitals that draw from Medicaid the most — those in line for more than $50 million annually — stand to see increases under DRG. Ten of these are "safety nets" and all but one is not-for-profit.

On the other hand, most of the hospitals that see the biggest increases under DRG are operated by for-profit companies.

Read more here.

Alex Sink backs Alan Clendenin in FL Dem Party chair race

Interesting high-profile endorsement for Alan Clendenin in his bid to lead the Florida Democratic Party: Alex Sink, the 2010 and possibly 2014 candidate for governor. To date, Clendenin opponent Allison Tant has soaked up all the establishment help, namely Sen. Bill Nelson and Democratic National Committee Chairwoman Debbie Wasserman Schultz. The press release:

Attorney General Pam Bondi's father Joseph Bondi dies

Attorney General Pam Bondi's father passed away Tuesday after an extended illness. The Associated Press is reporting that Joseph Bondi, 76, was a professor and former mayor of Temple Terrace and had been diagnosed with leukemia. Attorney General Bondi, whose full name is Pamela Jo, says her family is "heartbroken."

Around 8:30 a.m. Bondi posted the following on her Facebook page: 

My beautiful Daddy went to Heaven yesterday. He was surrounded by all his family. He fought a great fight with Leukemia. Thanks for all of your prayers and support. We are so heartbroken but comforted to know he is with our Lord. Please continue to pray for my family during this most difficult time in our lives.

This picture was also attached:

More from the AP:

Scott floats new tax break for manufacturers

Gov. Rick Scott is planning to cut taxes further for manufacturers in the coming year as a mechanism for creating more jobs and boosting the state’s manufacturing industry.

Scott announced Wednesday that he will seek a new sales tax exemption for manufacturers that purchase industrial equipment and machinery.

“We have 17,500 manufacturing companies in Florida today that employ more than 300,000 Florida families,” Scott said in a statement. “In the upcoming legislative session, we are committed to building up Florida manufacturing jobs by eliminating the tax barriers on companies who purchase equipment.”

Currently manufacturers already enjoy a tax exemption on machinery they purchase, but only if the machinery helps improve productive output by 5 percent annually. In 2012, Scott and the Legislature cut the requirement for productive output from 10-percent to 5-percent, saving manufacturers an estimated $46 million per year.

Scott is looking to eliminate the increase-in-production requirement altogether, allowing all manufacturers to purchase new equipment tax-free. Scott said the provision will make Florida more competitive with other states that don’t tax manufacturing equipment, and will boost exports.

“Eliminating the barriers on investment for our manufacturing industry will also benefit our ports and the many small businesses that support manufacturers,” Scott said in a statement.

It’s not yet clear how much money businesses will save from this tax break, although a similar proposal last year by Sen. Jack Latvala, R-Clearwater, was estimated to cost the state $153.4 million per year in lost revenue. That proposal did not pass, although a smaller tax break for manufacturers did, perhaps reducing the fiscal impact of this year's proposal.

The proposal to eliminate taxes on manufacturing equipment is part of a general trend—backed by Scott and the Republican-led Legislature—to chip away at the taxes paid by businesses.

In the last year alone, Scott has pushed for hundreds of millions of dollars in tax relief for businesses—ranging from corporate income tax cuts, targeted tax breaks for specific industries and tax exemptions for businesses that move to the state.

In November, voters rejected a constitutional admendment that would have cut property taxes for businesses that own equipment.

Last year, Scott announced plans to raise the exemption for corporate-income taxes further, from $50,000 to $75,000.

Democrats--who generally have voted for Scott's tax breaks--have become more vocal in lashing out at Scott's more recent tax-cutting proposals, arguing that Florida should be spending more on education and less on corporate tax breaks.

"On election night, the people of Florida sent a clear message that they have rejected Gov. Rick Scott's failed priorities and policies which have slashed funding for our public schools while giving hand outs to the corporate special interests who epitomize the broken politics of Tallahassee,"  said Florida Democratic Party Executive Director Scott Arcenaux in November. "But Governor Rick Scott apparently didn't get the message."

@ToluseO

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Florida gave subsidy to gun maker as part of job creation package

Bloomberg's Mike Bender reports today on tax breaks dished to gun manufacturers, raising questions about the $1.6 million tax subsidy given to Colt on Florida. An excerpt:

In Florida, Republican Governor Rick Scott hailed an incentive for the West Hartford, Connecticut-based Colt Manufacturing Co. in 2011 saying it showed the state was “a defender of our right to bear arms.” The deal, for 63 jobs, was worth about $1.66 million in state and local incentives, according to Enterprise Florida, the state’s economic development arm. The agreement penalizes the company $50,000 if it doesn’t produce all the jobs.

Frank Attkisson, a commissioner in Osceola County, which provided incentives, said it was a “sweetheart deal” for Colt and that the county would put tougher controls on future subsidies.

Florida state Senator Nancy Detert, the Republican chairwoman of the Commerce Committee, said she’s crafting legislation to make it more difficult to provide incentives for companies that don’t specialize in science and technology. She said she doesn’t want Florida to be known for gun manufacturing.

“We need to be a lot more careful and decide what kind of state we envision,” Detert said.