December 15, 2024  – In a recent announcement, Florida is preparing to funnel $143 billion into Medicaid managed care plans over the next six years. Representative Josie Tomkow, chair of the House Health and Human Services Committee for the 2025 session, highlighted the financial commitment during a legislative briefing aimed at detailing the state’s Medicaid strategy.

The funding announcement was made at the “Legislator University,” a forum designed to educate lawmakers on critical policies ahead of the legislative session. The Agency for Health Care Administration, which oversees Florida’s Medicaid program, has confirmed that the state will enter into six-year contracts with various managed care plans after a significant procurement process aimed at enhancing the efficiency and scope of healthcare services provided under the state program.

The managed care plans slated to receive these contracts include prominent providers such as Aetna Better Health of Florida, Florida Community Care, Humana Medical Plan, Molina Healthcare of Florida, Simply Healthcare Plans, South Florida Community Care Network (operating as Community Care Plan), Sunshine State Health Plan, and United Healthcare of Florida. These contracts are a part of a broader initiative to ensure that Medicaid recipients receive comprehensive and continuous care, maximizing the efficiency of healthcare spending in the state.

Despite plans to have the new contracts effective by the new year, Tomkow indicated a slight delay, with full implementation expected by “early 2025.” This timeline suggests a transitional period as the state shifts to these expansive new agreements.

In Florida, while the majority of Medicaid-eligible individuals are required to enroll in managed care plans, exceptions exist. These include persons with developmental or intellectual disabilities and women who qualify solely for family planning services. As of the latest data from October 31, Florida’s Medicaid enrollment stood at 4,307,965, with 3,063,777 of these individuals participating in managed care plans. Among the managed care providers, Sunshine Health currently serves the largest number, with 1,186,200 enrollees.

The strategic allocation of $143 billion to managed care plans underscores Florida’s commitment to enhancing the quality and accessibility of healthcare for its Medicaid population. By funneling significant resources into these contracts, the state aims to improve outcomes, reduce healthcare disparities, and ensure that its most vulnerable populations receive the care they need. As these new contracts unfold, they will likely be a focal point of healthcare policy and legislative oversight in Florida.