American Forum

By Toni Waters Woods

On Thanksgiving Day 2006, my father, James "Buzz" Waters, was waiting to be disenrolled from the Medicaid reform pilot program in Duval County so that a high-risk cardiologist in Alachua County would see him. Jacksonville cardiologists referred my father to the Alachua doctor because apparently there was not a high-risk cardiologist in the Duval County Medicaid reform program. This wait proved to be fatal.

Before Medicaid reform my father would have been able to immediately make an appointment and be seen by the cardiologist in Alachua county. Two years ago the state introduced a pilot program to North Florida and Broward county that required more Medicaid recipients to join Medicaid HMOs. Proponents of the pilot claimed that Medicaid Reform would result in increased choices of health plans and providers. But by forcing more Medicaid patients into Medicaid HMOs it has instead created new barriers to care. In fact patients are now unable to access specialists who accept Medicaid but are outside reform plan networks without experiencing unnecessary and sometimes fatal delays. Because the specialist my father needed to see was not part of Duval county's Medicaid reform network, he had to waste precious time going through the disenrollment process before he could even make an appointment with the out of network high risk cardiologist. New Medicaid plan enrollments only start at the beginning of the month. As a result, the time frame for effectuating disenrollment from a plan is a frustrating and ludicrous obstacle for high-risk patients who have immediate needs that cannot wait. My father didn't make it to December 1. He died on that Thanksgiving Day, November 23.