Study Examines Choice, Understanding Among Florida Medicaid Beneficiaries Participating In Pilot Program

Main Category: Medicare / Medicaid / SCHIP
Article Date: 15 Oct 2008 - 12:00 PDT

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About three in 10 Medicaid beneficiaries participating in a Florida pilot program were not aware of changes brought about by the program, namely that they were expected to choose a new health insurance policy for themselves, according to a study published on Tuesday in the journal Health Affairs, the Florida Times-Union reports (Cox, Florida Times-Union, 10/14). The program was launched in 2006 in Duval and Broward counties by the administration of then Gov. Jeb Bush (R), and was intended to let beneficiaries choose among policies offered by private insurers, with the aim of increasing competition among the plans.

For the study, researchers with the Kaiser Family Foundation, the Urban Institute and the University of Florida Center for Medicaid and the Underinsured surveyed 1,848 beneficiaries in the two counties from November 2006 to March 2007. Researchers found that three in 10 beneficiaries did not know they were supposed to choose a plan and many others were confused by the options. In Broward county, 56.3% said it was difficult for them to understand information about the health plans (Dorschner, Miami Herald, 10/14). In addition, the survey found that more than 60% of beneficiaries did not know they could opt out of the pilot program by using their Medicaid funding to purchase private coverage and about 30% did not know they were enrolled in the pilot program (Dolinski, McClatchy/Tampa Tribune, 10/14).

The Times-Union reports that when the number of people not aware of the changes is combined with those who opted to allow state officials to pick a plan for them, about half of the beneficiaries played no part in choosing their policy (Florida Times-Union, 10/14). According to the survey's authors, the program's viability "hinge[s] on the ability to translate complicated health care information for consumers" and "then help consumers use that information to make informed health care decisions." They added, "Without a well-informed consumer, a fundamental piece of the competitive model is missing, jeopardizing hoped-for efficiencies and cost savings" (Miami Herald, 10/14).

Samantha Artiga, a co-author and senior associate with the Kaiser Family Foundation, said, "The premise of the reform program is to offer plans of various packages to create more competition among the plans and create a more competent enrollee," but if the beneficiaries are "not actively making a choice of a health care plan, that's a key piece of the model that's missing" (Florida Times-Union, 10/14). She said that many beneficiaries reported both having low-incomes and being chronically ill, so "it will be important to continue to track how well they are able to engage in making a plan choice" (McClatchy/Tampa Tribune, 10/14).

A spokesperson for the Florida Agency for Health Care Administration said she could not comment on the study because she had not seen it (Florida-Times Union, 10/14).

The study is available online.

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