Since the Affordable Care Act was signed, most state governments have made the most of the federal grants flowing from Washington for health-system reform. Not Florida.
State agencies in Tallahassee have either not competed for grants or, on occasion, have won them but then given the money back. The latest: a $2.3 million grant for a toll-free consumer health information line. A Florida agency won it, records show, then decided not to take the money.
Florida got the lowest amount of ACA grant funding per capita – behind all 50 states and the District of Columbia – in 2011, according to a report by the University of Michigan’s Center for Healthcare Research and Transformation.
Its follow-up report, not yet posted, showed Florida did only slightly better per capita last year. It came in 48th, said Josh Fangmeier, health policy analyst at the center.
His data include grants that federal health agencies have given to community clinics, universities and local governments that applied without a state-agency sponsor. That’s why Florida received about $40 million in health grants in 2011 and about $82 million last year.
While state agencies received the bulk of federal health grants in other states, it was the reverse in Florida. State agencies accounted for less than one-tenth of the total last year: $7.6 million.
The grants Florida agencies received are mostly apolitical, for such things as training doctors and nurses and maternal-child health.
If a grant would advance the implementation of the ACA, community organizations apply for it directly. An example is the recent announcement that Florida health centers will receive $8.1 million to help uninsured Floridians sign up for coverage whenonline enrollment begins Oct. 1.
Florida’s avoidance of health grants has not drawn much attention – nowhere near as much as this year’s legislative decision not to accept federal funds to expand Medicaid. It is estimated that Florida would have gained $51 billion over a decade in federal funds, enough to cover about 1 million low-income uninsured people.
To some state officials, the refusal to seek or accept federal money is a badge of honor. In March, Florida House Speaker Will Weatherford told the American Conservative Union that states are being “coerced” into health reform “with the promise of free money.”
“They’re trying to buy us off, one by one,” said Weatherford, R-Wesley Chapel, referring to the Obama administration. “But I am not buying it. Florida will not buy it. And America should not buy it.”
To Laura Goodhue of Florida CHAIN, a health advocacy organization, this attitude inflicts considerable harm on the public.
“You’re only hurting your own constituents,” Goodhue said.
One of the most painful grants that Florida passed up, she said, was a five-year, $35.7-million “Money Follows the Person” grant that was intended to help patients who have physical or mental disabilities move out of nursing homes to less-confining residential care. The application had been filed before Gov. Rick Scott took office.
What was particularly irksome about the loss of that grant to advocates was that initially Scott had said the state would accept the money. But the Agency for Health Care Administration never asked the Legislature for spending authority for the grant.
“There were just a number of opportunities that Florida certainly should have taken up, but we didn’t,” Goodhue said.
While a lot of Republican-dominated state governments have resisted Obamacare, none has been as averse to seeking and accepting grant money as Florida. The state’s behavior was so unusual that two years ago it was the subject of a New York Times article.
At that time, state leaders said they weren’t accepting money tied to the ACA because they believed the law would be thrown out. Gov. Rick Scott told the Times, “I don’t want to waste either federal money or state money on something that’s unconstitutional.”
Last year, the U.S. Supreme C
ourt upheld most parts of the law. But Florida is still turning money away, including the $2.3 million grant for a Consumer Assistance Program. The Department of Elder Affairs won the grant in July 2012, issued a request for proposals, and after they were submitted, canceled the program in April.
The grant, as the federal Center for Consumer Information & Insurance Oversight described it, was for $2,344,000 to be spent in 2012-13 to “assist clients with questions and to provide technical assistance about their health coverage.”
Florida’s Consumer Assistance Program (CAP) grant application shows that the Department of Elder Affairs wanted to hire five temporary program specialists to answer questions from the public about the new and changing health insurance marketplace.
The elderly would continue to be referred to volunteers in the SHINE program (Serving Health Insurance Needs of Elders), as now. SHINE is a 20-year-old federally funded program that provides trained volunteers to help people over 60 figure out Medicare and other programs for which they qualify.
Most of the CAP grant money was to be used to beef up the toll-free phone network that SHINE uses and conduct a marketing campaign for the free information service. Putting the acronyms of the existing and new programs together, it was to be the “SHINE CAP” program.
The Department of Elder Affairs posted a request for proposals on March 15. Marketing and advertising companies were jazzed at the prospect of competing for a $2 million grant.
Michelle Ubben, chief operating officer for Sachs Media Group in Tallahassee, said a team there worked hard on their proposal for a multimedia campaign.
“It was right within the sweet spot of what the company does,” she said. “We felt like it was an exciting piece of work and we were eager to go after it.”
They came up with an elaborate campaign around “wayfinding,” using colors and signs to help people find their way through a complex system.
“ We were really excited about this being a signature project for next couple of years that could improve the lives of Floridians and help an agency of government do its job better and take advantage of a historic opportunity,” Ubben said.
They were disappointed when the department canceled the project shortly after the deadline for proposals. All the applicants were told was that the money wasn’t available after all.
The decision came right after two top officials there received an e-mail from the Florida House. Eric Pridgeon, health and human services budget analyst there, sent the e-mail April 7 to two officials at the Department of Elder Affairs, Legislative Affairs Director Adam Lovejoy and Chief Financial Officer Jon Manalo.
In it, he wrote: “Can you advise how you will implement this grant/procurement? Will you be coming to the LBC for budget authority? Please advise.”
LBC is short for Legislative Budget Commission.
The commission, which has some members from the House and some from the Senate, reviews budget and personnel actions by executive agencies or the courts to make sure they don’t violate the intent of the Legislature.
“We did not have the legislative budget authority to move forward,” Elder Affairs spokeswoman Ashley Marshall said in an email. “Therefore, the grant was returned.”
A request to interview those involved in the decision—Lovejoy, Manalo and presumably Secretary Charles Corley – was denied.
Similarly, Pridgeon did not respond to calls and emails. House spokesman Ryan Duffy said, “Our House staff raised the concern that Obamacare’s a law that’s going to impact Floridians of all ages and so there was concern that the award was given to an agency that deals with elder affairs.”
Tallahassee consumer health advocate Brian Lee of Families for Better Care says he can hardly believe the state turned down the money for something as useful as an information line. Taking the money, he said, “seems to be a no-brainer.”
The grant, as the federal Center for Consumer Information & Insurance Oversight described it, was for $2,344,000 to be spent in 2012-13 to “assist clients with questions and to provide technical assistance about their health coverage.”
Florida’s Consumer Assistance Program (CAP) grant application shows that the Department of Elder Affairs wanted to hire five temporary program specialists to answer questions from the public about the new and changing health insurance marketplace.
The elderly would continue to be referred to volunteers in the SHINE program (Serving Health Insurance Needs of Elders), as now. SHINE is a 20-year-old federally funded program that provides trained volunteers to help people over 60 figure out Medicare and other programs for which they qualify.
Most of the CAP grant money was to be used to beef up the toll-free phone network that SHINE uses and conduct a marketing campaign for the free information service. Putting the acronyms of the existing and new programs together, it was to be the “SHINE CAP” program.
The Department of Elder Affairs posted a request for proposals on March 15. Marketing and advertising companies were jazzed at the prospect of competing for a $2 million grant.
Michelle Ubben, chief operating officer for Sachs Media Group in Tallahassee, said a team there worked hard on their proposal for a multimedia campaign.
“It was right within the sweet spot of what the company does,” she said. “We felt like it was an exciting piece of work and we were eager to go after it.”
They came up with an elaborate campaign around “wayfinding,” using colors and signs to help people find their way through a complex system.
“ We were really excited about this being a signature project for next couple of years that could improve the lives of Floridians and help an agency of government do its job better and take advantage of a historic opportunity,” Ubben said.
They were disappointed when the department canceled the project shortly after the deadline for proposals. All the applicants were told was that the money wasn’t available after all.
The decision came right after two top officials there received an e-mail from the Florida House. Eric Pridgeon, health and human services budget analyst there, sent the e-mail April 7 to two officials at the Department of Elder Affairs, Legislative Affairs Director Adam Lovejoy and Chief Financial Officer Jon Manalo.
In it, he wrote: “Can you advise how you will implement this grant/procurement? Will you be coming to the LBC for budget authority? Please advise.” LBC is short forLegislative Budget Commission.
The commission, which has some members from the House and some from the Senate, reviews budget and personnel actions by executive agencies or the courts to make sure they don’t violate the intent of the Legislature.
“We did not have the legislative budget authority to move forward,” Elder Affairs spokeswoman Ashley Marshall said in an email. “Therefore, the grant was returned.”
A request to interview those involved in the decision—Lovejoy, Manalo and presumably Secretary Charles Corley – was denied.
Similarly, Pridgeon did not respond to calls and emails. House spokesman Ryan Duffy said, “Our House staff raised the concern that Obamacare’s a law that’s going to impact Floridians of all ages and so there was concern that the award was given to an agency that deals with elder affairs.”
Tallahassee consumer health advocate Brian Lee of Families for Better Care says he can hardly believe the state turned down the money for something as useful as an information line. Taking the money, he said, “seems to be a no-brainer.”
–Carol Gentry, Health News Florida
Robert says
The confounding variable here is that the citizens who it would help the most think that these state legislators represent them and they continue to vote them into office.
These legislators have health care 1 out of 5 Floridians don’t.
Blondie says
I have been trying to get help for my son to see a doctor he injured his shoulder and needs the right doctor I have been trying to get him the help he needs for 8 months or more. This is effecting his work he is depressed we have no insurance can hardly pay for basic needs. What fools the are.
John Boy says
Who did you vote for? If you are a Republican you got exactly what you wanted. If on the otherhand you voted Democractic, ACA will be fully implemented in January but the Fraudster and the Tea Baggers are trying to make Floridans suffer without getting the care they are entitle too unser ACA.
Nancy N. says
The Rick Scott administration, to spin an old cliche, is “cutting off its nose to spite its face”. They are throwing their constituents under the bus out of spite at the Obama administration. Who do they work for, anyway – us or the RNC? Oh wait, I already knew the answer to that…
A.S.F. says
This is shameful. If accepting the grant money is a no-brainer, it only shows that some Florida politicians are all hot air and have LESS than no brains. What they do have, instead, is a a need to cater to a self-absorbed constituency that have neither the compassion or common sense to see that it is worthwhile, in the long run, to help those less fortunate–especially if it might cut into their piece of the pie. What makes this especially objectionable is how many of these nay-sayers like to present themselves as SUCH fine upstanding Christian citizens. UGHH!
Kip Durocher says
Way to go Tallahassee. Show them how the Florida GOP operates, caring about nothing but private meetings with the Chamber of Commerce. Why bother to help the working poor and seniors. Why bother to have any type of health information available for citizens with questions “glow” scott and his ilk have a short list of concerns/ 1) lining their pockets with money 2) keeping the 1% and the corporations fat and happy.
To hell with the rest.
Good work glow and the repuglicans ~ you will soon have Florida and the middle class in ruins.
Thanks to all you lower information voters who bought into glow’s 72 million dollars (his own money from earned by defrauding medicare thru HCA) worth lies he plastered all over the media.
RHWeir says
Here’s the deal about ACA. For us, personally, it has already cost us directly over $200 a month. When my pension system was informed the health care laws now required that children up to 26 must be included, they dumped all spouses. So, we had to get private health insurance for her. We won’t qualify for help from the exchanges, it’s based on the FPL (it’s a welfare program) and we won’t get help there. So, in 2014, our estimated premium for my wife will be over $300. We’ll pay more, our taxes will support more Medicaid and we get nothing in return since we’re middle class. Also, Medicaid funds usually come with matching state funds and administrative costs, so Scott is right to be wary of them. I’m a Democrat but the Obama mess has pushed me toward independent. The other thing about Medicaid expansion is, it won’t pay for itself, this money comes from somewhere and it comes from you and me and the deficit. For once, I think Scott is actually doing the right thing. Health care for all is a great idea and I’ve hoped for it for years but the ACA is so flawed, it won’t work. Employers will schedule less than 40 hours, it should include all employees, not just fulltime. Already, providers just upcode mandatory procedures. So, it’s back to the drawing board and start over again. It’s just more welfare and that’s the last thing we need.
Anita says
It sounds as though you beef is not with Obama and the ACA but with your insurer for abruptly dropping your spouse. Of course, my husband’s insurance included me only for an exorbitant rate, and I found reasonable coverage only through my job. Now that we’re both retired and insured with Florida Health Care, our premiums and attendant costs seem reasonable, so I’m willing to wait until ACA goes into effect fully before making any decisions about it’s efficacy.
RHWeir says
You don’t get it. My pension plan, not my insurance provider, dropped coverage for my spouse because the ACA required them to cover children to age 26 but the ACA does not require spousal coverage. The pension plan dropped spouses so they could afford the ACA requirement to include children up to 26. Unless you are lower income you will not receive a rebate for health insurance.If you are middle class, the ACA will not help you. The income limit for any discount at all is 400% of the FPL and the 400% discount level is not much at all. This information is and has been available at, http://www.ehealthlink.com/exchange/acaroles.aspx, among other sites. This is not the national health insurance I hope and voted for, this is more welfare. Yes, Medicaid is welfare.
Nancy N. says
Where is it written that you have to get back a benefit or service for every dollar you pay in taxes? Taxes are the price you pay for living in a civilized society.
Excuse me if I don’t feel sorry for you for saying that you don’t qualify for the exchanges. If you make more than $90k for a family of four, I’m not crying a river for you. I’m self-employed and supporting a family of three on barely a third of that and am uninsured because no one will sell me insurance due to my medical condition. Which means that I’m paying several hundred dollars a month OUT OF POCKET for my own medical treatment – and still going without urgently needed care. The ACA and the Medicaid expansion (we make less than 133% of poverty) were supposed to save my life. Now, since Rick Scott turned down the Medicaid expansion, I’m right back where I started – as one of the people screwed over and left without healthcare AGAIN.
Michael Schottey says
Companies deciding to take advantage or gash you before ACA takes effect is exactly why ACA needs to take effect.
Sherry Epley says
Again, this governor and his stubborn political stances, that often work to the detriment of Florida’scitizens, needs to go. . . and his cronies in the state legislature, as well! VOTE SCOTT OUT!
markingthedays says
Good job Florida
Magnolia says
Let’s buy that fancy new car today with all the bells and whistles. When the warranty expires in 2-3 years and we have to pay the entire cost ourselves, what then?
I believe that’s what he’s looking at.
A.S.F. says
Oversimplification, much?
Magnolia says
ASF: Not allowed in an Obamanation?
Nancy N. says
Sorry I don’t view paying to help keep people like me ALIVE with desperately needed medical care as a “fancy new car”. That analogy is an insult that considers poor people expendable.
Magnolia says
I have a serious preexisting condition as well, Nancy. And my first priority my entire life is to make sure I have health insurance. State Medicaid is available now.
The analogy was never meant to be an insult only make the point that WE get stuck with the entire bill in about 3 years, when that grant money runs out. Many are under the assumption this is free healthcare. It is not. Governor Scott is trying to keep us out of bankruptcy. If you think that is cruel, there is nothing I can say to you that will help.
Nancy N. says
What you (and a lot of other people aren’t getting) is that when Gov Scott turned down the Medicaid expansion he hung me – and a lot of other people like me – out to dry regarding medical care. A donut hole was created that actually denies healthcare assistance to some of the people who need it the most. There is a gap created now between the top level of people who are eligible for Medicaid, and the bottom level of people who are eligible to purchase insurance, and receive insurance assistance credits, through the new exchanges. A whole lot of people are going to fall through that gap. Because of this there are people who are living below poverty line that will actually be receiving less government assistance for their insurance (actually no assistance) than those who are making 2-3x the poverty level.
Under the system created by Gov Scott when he turned down the Medicaid expansion, if you make $89,000 a year for a family of four, you can buy insurance on the exchanges and get a nice tax credit that helps you pay for it. BUT if you make $25,000 a year to support that same family YOU GET NOTHING. You cannot buy insurance on the exchange, and therefore do not have access to the tax credit assistance programs available through the exchanges to help you pay for insurance. You are also ineligible for Medicaid. You are totally screwed. Explain to me how that is fair? That people with more income get more assistance paying for their insurance through a loophole Scott created in the law and the poorest people get nothing? Oh yeah, that’s right, he doesn’t give a rat’s ass because poor people don’t write campaign checks.
My first priority my entire adult life has been to ensure I have medical insurance as well. BUT I CAN’T FIX THIS. There is simply no way under the current system, or the ACA system about to take effect, for me to get insurance. Under the current system no one will sell it to me at any price (since I don’t have access to an employer plan) and under the ACA system I will fall into the donut hole where I won’t receive any subsidies thanks to Gov Scott and will therefore not be able to afford it.
Gov. Scott isn’t trying to keep us out of bankruptcy. This is about politics and his refusal to have anything to do with helping to make Obamacare a success. He’s said so himself. And why else would he be ordering his state government to do things like turn down one-time grants of funds, which will not result in further expenses to the state down the line, to do things like help explain the law to FL residents during the initial sign-up period? He’s doing everything possible to ensure it is a failure, even if the programs involved do not and will not ever cost the state a single dime.
Anonymous says
Rick Scott appears to be as intelligent as a pile of rocks!!
Ben Dover says
That`s why this Millionaire Scott has got to go, he turns all help away that the people who,ve lost their jobs and homes and insurance need , him and his rich cronies , but mainly Bush with his war monger mentality destroyed our economy, he turned away the Sun rail which would have created many jobs and helped people save on fuel costs commuting, its still being done , but would have been done in many area`s and running had he approved Gov funding, he lied ,said he was for bringing Obama care here , but he made sure his friends voted it out , was just a ploy to get re-elected, like his sudden concern for teachers , he`s a lying , deceiving , Romney clone, that would rather gas lower income families then help them out, but he wants our votes, so he pretends to care , a wolf in sheep`s clothing, the republicans cost us our jobs and houses and lack of medical care, by lying their way into Iraq costing the country 12.5 billion a month for ten yrs , that with the Afghanistan war crippled our economy, and if they`d had their way we`d be at war with Iran too, cause when your rich you invest in companies that supply the war machine, they get richer , and we get poorer , then they swoop in and buy our houses dirt cheap and flip them , mean while we are either living with family or in the woods and any help the current president tries to extend us and the rest of the country, the republicans in the house and senate block him from doing. Scott and his ilk have to go , they are trying to exterminate the people they,ve destroyed, trying to take away our health , our retirement , anything we worked for our whole lives for ,they don t want to pay up , forget a race war there`s gonna be a class war first , cause if we don t do something soon , the rich will eradicate the poor and Scott is doing his damned best here in Florida.
John Ell says
This issue should be put on the ballot and teach this egomaniac a lesson that the VOTER RUNS THE COUNTRY NOT ELECTED OFFICIALS.
The majority of voters shun Obama’s health care program and don’t want it. Get rid of it before it bankrupts the country. Those who don’t agree have a choice just as the Prime Minister of New Zealand said to the Muslims – this is the way we do it in this country and if you don’t like it you can leave.
Ben Dover says
Well John Ell Obama care would have worked , its like any other insurance policy the more people that participate, the cheaper the rates , but racist republicans that are trying to sabotage Obama`s presidency changed it ,gave Gov`s of each state the power to use it or not, and what a surprise, 34 republican Govs blocked it their state, THATS why it failed, it would have helped the whole country get cheaper insurance , with better benefits and no pre existing condition blocking , but the greedy thieving bribe taking republicans in the senate who get 500.000 a yr from drug companies and insurance companies to charge whatever they want for drugs and create loopholes to avoid paying claims is going to keep on happening now , glad you like being bent over by your politicians , I don t ,and it has to stop .
foghorn leghorn says
“Fuck the poor.” — Rick Scott, every Florida GOP member
Geezer says
I tip my hat to you, Foghorn.
rickg says
Maybe Rick Scott knows how easy it is to abscond with Medicare and Medicaid funds so he’s trying to protect us from the likes of himself.
A.S.F. says
…Or maybe he just hasn’t figured out a way to profit off of it himself without getting caught, the way he tried to do with Medicaid in the past. For Governor Scott, of all people, to pontificate about how healthcare concerns should be handled in Florida, morally, legally, financially or otherwise, is disgusting.
blondee says
Nice going Flori-duh!!!!
John Boy says
I’ve got good insurance that I don’t pay for, so I will not benefit from ACA. I still support it but it looks like many Flagler residents would rather die without health care. So all I can say is that Flagler will probably be better off as the Tea Baggers die off because of their bigotry and misguided principles, political suicide.
Geezer says
A Florida Prayer:
If I get sick – may it not be in Florida.
If I become unemployed – may it not be in Florida.
If I lose my home – may it not be in Florida.
Deliver me from this swirling vortex of stupidity.
And deliver me from Rick Scott.
Amen.
Amen
Joe Flurnch says
There is no such thing as free lunch. Obamacare is built on a house of cards and will surely collapse under its own weight. Be a little patient. You will see the States getting on this perceived gravy train will pay in the end.
A.S.F. says
You mean the way that Medicare is built on a house of cards? Shall we calculate how much all the people on Medicare put into the system and cut them off the minute they exceed that amount, plus reasonable interest? Sayonara, freeloaders! THAT is what is backrupting our government and our healthcare system faster than anything, yet, you don’t hear the Tea Party asking for any less benefits for themselves! Our population is aging and, with so many uninsured people of all ages already suffering, we can’t afford the luxury of doing nothing and changing nothing. Let’s give the ACA a chance and, if and when revisions need to be made, let’s make them, keeping the welfare and best interests of ALL of us in mind.
Magnolia says
ASF: You DO realize that people on Medicare PAY for it, don’t you? And that includes any amount they exceed. Your president has already cut plenty from Medicare and now he is working on the military.
A.S.F. says
Magnolia–Medicare recipients pay for any amount they exceed having put into the system, even after they are no longer contributing money into the system? You mean math doesn’t apply to them, the way it does for others? Their bank accounts magically replenish themselves after they use up the money in them? People on Medicare today have paid a certain amount into the system during their working life (some of them, I should say–some never worked a day in the workforce or contributed to it monetarily at all, such as those good mommies who stayed home to raise their children and those with profound disabilites..) I’m not saying those individuals don’t deserve healthcare. But, if I followed your reasoning and your moral lead, I might have to say that, in order to be fair. Actually, I should take a moment to further correct myself–The money today’s Medicare recipients paid into the system paid THEIR parents bills. What was left over after that, once they retired, started going towards THEIR bills. And today’s Medicare recipients are living longer, and placing more of a burden on the healthcare system, than their parents did. PLUS they are now getting prescription coverage, which their parents never did. Now YOU do the math. Should we cut them off, once the amount they actually paid into it, with interest tacked on, is exceeded? Because, you know, then they are dependent on someone else’s dime paying for their needs. In other words, THEY are on welfare and are dependent on someone having compassion enough to say to them: No, will not cut you off now that you are too old or sick to work. We are not going to desert YOU in YOUR hour of need. We are not going to blame you or consider you to be morally objectionable for being a drain on the system. The President is trying to cut WASTE and find ways to make healthcare operate more efficiently and fairly. As far as the military goes, Obama is trying to find ways to cut the bloat and redundancy in the humongous Defense Budget without compromising our safety and security. I don’t find anything objectionable in that, although I do find it objectionable when Republicans in Congress insist on passing budgets that include building weapons systems that even the military says they don’t want or need. THAT, Magnolia, makes NO sense to me at all.
Sherry Epley says
I want to hear that all those shouting against the ACA, Medicare and Social Security are going to personally say “thanks but NO thanks”. . . “I am an island, I will grow my own food and build my own car and roads. I will buy more guns and protect my family. I will grow the cotton to make my own clothes. I will put out my own fires and no flood or medical crisis will touch me. I will never grow old, and money will always fall from my tree”. Blessed are those RNC, FOX News believers!
Geezer says
I will build an MRI machine out of spare auto parts, I’ll take the family’s feline pet
and force it do cat-scans, and at the end of the day we’ll have a toilet-seat -toss
for kicks and giggles. (laughter is the best medicine, right?)
As for myself, I plan to specialise in DIY-OB/GYN.
Former President Bush once said: “Too many OB/GYN’s aren’t able to practice their love with
women all across the country.” I’m fixin’ to fix that, one patient at a time.
To Medicare and Social Security: TOOEY!
Let dem old-timers die off.
I can take their guns after they croak for the last time.
By golly, Florida is truly the land of opportunity!
Go home you Yankee carpetbaggers!
Healthcare my eye! (ow, my eye!)
Magnolia says
ASF: Not going to cut me off? When the money runs out, the benefits run out. Thanks for the lesson in civility. I think I’ve proved my point.