Last Updated Apr 2, 2010 5:01 PM EDT
Meanwhile, Florida, like many states, faces a budget crisis caused by declining revenue and increased costs. Revenue has been falling due to the global economic downturn, which hammered sales tax collections, real estate prices, and personal incomes. Florida's real estate market is one of the hardest hit in the nation. The state has had a hard time balancing its budget over the last few years, and 2010 was no exception.
Health care is part of the state's solution. In the proposed budget, Florida hopes to transfer more of its Medicaid patients into managed care plans. Medicaid is a joint Federal and state program that provides care for low income residents. Each state contributes funding, as does the national government. The states manage the program as they see fit.
In the new budget, more of the Medicaid program in Florida would be privatized. A pilot program had been in effect since 2005, but the new budget expands this into several more counties. It is hoped this movement of people into managed care and HMO's will save the state over $25 million in annual funding.
Some in the state Senate have proposed a more sweeping change, where vouchers would be provided to Medicaid participants to buy insurance. This would require the approval of the Federal government, and there are several more steps that must be taken before a request could be submitted.
Florida hopes to reduce spending by managing care better. Yet as with any effort aimed at government spending, there are arguments over whether plans like these will work and provide more care for less money.
It also illustrates that even without Congressional action, efforts to reform health care or control costs will occur naturally over time. Just don't be surprised if those efforts take place at the state and local level, rather than the nation as a whole.