The Senate Health Policy Committee on Tuesday delayed Department of Health Secretary John Armstrong‘s confirmation process after the secretary refused to answer whether expanding Medicaid would improve Floridians’ healthcare outcomes or whether he supported the Senate’s alternative proposal to expand Medicaid.
State Sen. Aaron Bean asked Armstrong to return soon and said the committee looked forward to continung the hearing “very soon.”
Initially, state Sen. Don Gaetz asked Armstrong about his position on the Oregon Medicaid health insurance experiment, which used a lottery system to pick who would be eligible for a Medicaid expansion and who wouldn’t. Two years after the lottery experiment researchers found that Medicaid had no statistically significant impact on physical health measures, though it did increase use of healthcare services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.
Gaetz tried twice to get Armstrong to answer questions about the Senate FHIX plan and whether he supported the plan. Armstrong both times avoided directly answering the question.
State Sen. Arthenia Joyner, who had pressed Armstrong earlier in the confirmation process about infant mortality rates among African Americans, then asked whether the Governor’s Office had told him not to answer questions. “I am under no constraints,” Armstrong told the committee.
When she pressed whether he had an opinion on whether the Senate plan would improve care, Armstrong replied, “I have not formulated an opinion. My focus remains on the principal determinants of health, which remain the behavioral, and the social and environmental, and that is where a lot of tough work remains. There is not a quick solution to retool the environment so that healthy choices become the easier choices,” Armstrong said.
After Armstrong’s reply state Sen. Bill Galvano moved that the confirmation be temporarily deferred.
Galvano said after the meeting that the minority leader and the former Senate president asked the same question but did not get satisfactory answers.
“Hopefully, with temporarily postponing this confirmation it will give the surgeon general time to reflect and be able to give us an answer on what the DOH’s position is on our health exchange and our approach to the Low Income Pool,” Galvano said.
Armstrong immediately left the committee room and agreed to take one question from a reporter. When asked whether his refusal to comment on Medicaid expansion was the reason the committee deferred action, Armstrong replied that he was “committed to the health of nearly 20 million Floridians and 2 million visitors on any given day.”
Armstrong’s refusal to anser whether he supports or opposes a Medicaid expansion follows the lead set by his boss, Gov. Rick Scott, who released a statement on Monday after refusing to answer reporters’ questions on whether he supports a Medicaid expansion or supports the Senate’s alternative approach, which would use traditional Medicaid dollars available under the federal healthcare reform, often referred to as Obamacare.
Scott’s statement on Monday said “it would be hard to understand how the state could take on even more federal programs that (the federal government) could scale back or walk away from.”
After funding the Low Income Pool — a supplemental pot of Medicaid funding to pay the costs of the underinsured and uninsured for nine years — the Centers for Medicare and Medicaid Services advised Florida last April that it would not continue to fund the LIP beyond this summer.
The Low Income Pool and Medicaid expansion have threatened to throw the 2015 regular legislative session into overtime. The Senate has included a Medicaid expansion as well as LIP dollars in its proposed spending plan for the 2015-16 fiscal year while the House has neither in its budget. As a result the two chambers are more than $4 billion apart in their spending proposals. Additionally, the Senate has refused to pass tax cuts without having a resolution on the LIP dollars, whereas the House has passed $690 million in tax cuts.
