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Office of Program Policy Analysis and Government Accountability

Medicaid Reform: Few Beneficiaries Have Participated in the Opt-Out Program, Report No. 08-37, June 2008
 
Full report in PDF format


  • The Medicaid opt-out program is a component of Florida’s Medicaid Reform initiative administered by the Agency for Health Care Administration.  The program allows eligible beneficiaries to participate in their employer-sponsored health insurance plan as an alternative to enrolling in a Medicaid Reform plan.  Beneficiaries choosing this alternative use their Medicaid premiums to purchase individual or family health insurance.
  • To date, the opt-out program has not been widely used.  As of the end of March 2008, only 19 beneficiaries were enrolled in the opt-out program while a total of 30 beneficiaries had enrolled since September 2006.  Eleven beneficiaries had disenrolled because they were no longer eligible for Medicaid or lost access to employer-sponsored insurance.

Which Government Program Summaries contain related information?

Agency for Health Care Administration
Medicaid Health Care Services

What other OPPAGA-related materials are available?

  • Report No. 09-29 Medicaid Reform: Legislature Should Delay Expansion Until More Information Is Available to Evaluate Success,published in June 2009.
  • Report No. 08-64 Medicaid Reform: Reform Provider Network Requirements Same as Traditional Medicaid; Improvements Needed to Ensure Beneficiaries Have Access to Specialty Providers, published in November 2008.
  • Report No. 08-55 Medicaid Reform: Oversight to Ensure Beneficiaries Receive Needed Prescription Drugs Can Be Improved; Information Difficult for Beneficiaries to Locate and Compare, published in September 2008.
  • Report No. 08-54 Medicaid Reform: Risk-Adjusted Rates Used to Pay Medicaid Reform Health Plans Could Be Used to Pay All Medicaid Capitated Plans, published in September 2008.
  • Report No. 08-46 Medicaid Reform: Choice Counseling Goal Met, But Some Beneficiaries Experience Difficulties Selecting a Health Plan That Best Meets Their Needs, published in July 2008.
  • Report No. 08-45 Medicaid Reform: Beneficiaries Earn Enhanced Benefits Credits But Spend Only a Small Proportion, published in July 2008.
  • Report No. 08-40 Medicaid Reform: Two-Thirds of the Initial Pilot Counties’ Beneficiaries Are Enrolled in Reform Plans, published in June 2008.
  • Report No. 08-38 Medicaid Reform: More Managed Care Options Available; Differences Limited by Federal and State Requirements, published in June 2008.

Copies of this report in print or alternate accessible format may be obtained by telephone (850/488-0021), by FAX (850/487-9213), in person, or by mail (OPPAGA Report Production, Claude Pepper Building, Room 312, 111 W. Madison St., Tallahassee, FL 32399-1475).
e-mail address: oppaga@oppaga.fl.gov


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