NEWS

Florida Blue and Humana Expand Senior Care Clinics

• Florida Blue is opening its first senior primary care clinic in Jacksonville, Florida while Humana’s senior focused CenterWell clinics continue to expand their presence across the state. Florida Blue is partnering with Sanitas Medical Center to provide primary care for members that are 50 and older and Medicare members of all ages. They will provide a range of services including preventive and primary care, chronic condition management, mental health services, labs, imaging, and a pharmacy. Additionally, they will offer a community space for education, wellness classes, and activities. Meanwhile, CenterWell plans to open primary care centers in Florida, Indiana, Kentucky, Louisiana, North Carolina, Mississippi, and Virginia (Health Payer Specialist, February 2).

Study Reports Public Option Could Cost Minnesota

• Last year, the Minnesota legislature required the Department of Human Services (DHS) contract for an independent study and report to analyze public option health models. The study looked at potential impacts of expansion for MinnesotaCare as the state considers expanding its public option health insurance. The report estimates that it could cost the state up to $364 million more each year and add up to 151,000 individuals to insurance rolls. MinnesotaCare is currently available to those who are financially ineligible to obtain Medicaid coverage and have an income of up to 200% of the federal poverty level (FPL). The report analyzes what could happen in different scenarios and concludes that additional research should be done to determine how an expanded public option would impact health disparities (Health Payer Specialist, February 5).

As Florida Lawmakers Maintain Opposition to Medicaid Expansion, Ballot Efforts Emerge to Create Change

• While healthcare is a focus of the current legislative session in Florida, Medicaid expansion is currently not part of the agenda. Medicaid expansion in Florida would mean that those residing in the state earning up to 138% of the FPL would qualify for health insurance. Estimates indicate that in the first two years of expansion, Florida would qualify for about $5.6 billion in federal aid, and $4.4 billion going forward. While Republican legislators continue to oppose Medicaid expansion, polls show a high percentage of Floridians support it. Advocacy groups are rallying together to launch a ballot effort to qualify for the 2026 ballot and get the topic of Medicaid expansion to the voters that November. If the ballot is approved and gets support from at least 60% of voters, an amendment requiring Medicaid expansion could be added to Florida’s constitution (USA Today, February 1).

Mississippi House Passes Bill to Address Infant Mortality Ranking While State Hospitals Continue to Push for Medicaid Expansion

• According to the 2023 Mississippi Public Health Report Card, the state is ranked 50^th in the country for infant mortality, with Black infants nearly twice as likely to die when compared to white infants. To improve poor health outcomes for mothers and babies, the Mississippi House passed a bill on Wednesday that would permit up to 60 days of Medicaid presumptive eligibility for pregnant individuals 19 years of age and older, starting July 1. Presumptive eligibility is estimated to cost the state less than $600,000 a year. This bill comes just before state hospital owners called on Governor Reeves to expand Medicaid. Significant research highlights the financial and health benefits of expansion, and most Mississippians want Medicaid eligibility expanded. Should Medicaid presumptive eligibility for pregnant women occur in the state, it is expected to provide health insurance to 200,000 to 300,000 additional individuals while helping strained hospitals and bringing additional federal dollars into the state (ABC News, January 31; Yahoo, February 2).

Oklahoma Enacts “Any Willing Provider” Law After Caremark Sues Oklahoma Attorney General

• Oklahoma is the latest state to enact an “any willing provider” law that permits any pharmacy to fill prescriptions for health plan members. This new law comes on the heels of Caremark suing Oklahoma’s Attorney General, Gentner Drummond, claiming that the state is incorrectly imposing its freedom of choice law on health plans that are regulated by federal regulations. The any willing provider laws generally benefit small pharmacy providers and such laws often conflict with pharmacy benefit manager (PBM) guidelines that require plan members to use certain, approved pharmacies when filling prescriptions. Health law specialists throughout the country believe that this case, and others similar to it, could be heard by the U.S. Supreme Court (Health Payer Specialist, February 2).

Florida and Georgia File Suit Against HHS Over Medicaid Program Requirements

• Florida and Georgia both filed suits against HHS on February 2 regarding their Medicaid programs. Florida has filed a suit regarding the 12-month continuous coverage requirement for children. As a part of the 2023 federal spending bill, states are required to maintain one year of Medicaid or CHIP eligibility for children, beginning on January 1, 2024. However, Florida seeks an exception so that it can drop beneficiaries if their families don’t pay the CHIP monthly premiums, which are currently between $15 and $20. Georgia is suing the Biden Administration after CMS denied the state’s request to extend its partial Medicaid expansion known as the Pathways program. Pathways was initially approved for a five-year period (October 15, 2020 through September 30, 2025), but implementation was delayed due to a court battle over the program’s work requirements (Inside Health Policy, February 2).