Jeb Bush apparently thinks the "compassionate conservative" idea that his brother so cynically ran on will work for him, too. He's using his Medicaid experience in Florida as evidence that he really cared about the poors, that he was reforming Medicaid to give them
"more power to choose from more choices." Of course, it was really just about privatization, but that's not how Bush is going to frame it in his attacks on Obamacare. Which, by the way, he says he would repeal.
On the campaign trail, Bush describes how his Empowered Care pilot program tamed runaway costs. He said recently in New Hampshire, “We need to reform Medicaid, and there’s a plan to do that in Florida that’s a pretty good one.”
But while Bush’s plan, enacted while he was governor, did promote greater choice among private managed-care options, it also sparked a backlash among activists who charged that the very low-income Medicaid population often ended up with less care than under traditional Medicaid.
Rather than allowing more choice to improve upon traditional Medicaid, Bush's liberal critics say he gave private managed-care plans too much leeway to design the benefits, which allowed them to "cherry-pick" the healthiest, lowest-cost beneficiaries. Networks of hospitals and doctors were limited. And consumers found the lack of standard benefits confusing; some ended up with inadequate coverage that didn't give them the health care they needed.
The facts actually back up "liberal critics" on the failures of Bush's experiment, particularly for children. For example, a federal judge
ruled early this year that the plan, continued under Gov. Rick Scott, neglects needy children and doesn't comply with federal law. The reimbursement rates, the judge ruled, are set so low that providers opt out and have created a shortage of pediatricians serving the neediest children. In
fact, in 2013, "almost half the children covered by Florida's Medicaid program didn't get the recommended number of doctor visits in their first 15 months, putting Florida in the bottom quarter of Medicaid plans nationwide."
That's a drop in the bucket of failures. Again, in 2013, nearly one-third of pregnant women didn't get health care in their first trimester, and only half had a postpartum visit within two-months of giving birth. Among adults age 46 to 85, only half who were diagnosed with high blood pressure got adequate treatment, and more than half of them who were diagnosed with diabetes did not get eye exams to check for and treat glaucoma. Only 45 percent of the diabetes patients had their blood-glucose levels adequately controlled.
Sure, maybe Bush's plan was able to reduce costs, but it did it through reducing care, all in the name of "patient choice." And, as usual with Republican plans, it was about transferring public money to private care and the hell with the patient. And never forget that Bush's grand experiment didn't do a thing about Florida's uninsured rate, which has been second only to Texas. All of which Bush calls a complete success. Echoes of his brother and "mission accomplished."