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Teresa A. Coughlin, Sharon K. Long, Timothy Triplett, Samantha Artiga, Barbara Lyons, R. Paul Duncan, and Allyson G. Hall Florida’s Medicaid Reform: Informed Consumer Choice? Health Affairs, November/December 2008; 27(6): w523-w532. [Abstract] [Full Text] [PDF] [Reprints & Permissions]

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Comment on Coughlin paper

Grace-Marie Turner   ( 12 November 2008 )

Author response to Turner comment

Terri Coughlin, Sharon K. Long   ( 14 November 2008 )

Comment on Coughlin paper 12 November 2008
Grace-Marie Turner, President Galen Institute Send comment to journal: Re: Comment on Coughlin paper gracemarie{at}galen.org Grace-Marie Turner	The study about Florida’s Medicaid reform project gives the program poor marks regarding informed consumer choice. However, the telephone survey upon which the study is based was conducted between November 2006 and March 2007, yet the target population for the survey was being enrolled from September 2006 to April 2007. Clearly some people were interviewed before enrollment had been completed. Wouldn't it have been more useful to conduct the survey after enrollment had been completed so more people were more fully informed? Also, the study continues to report results as poor when they could easily be read as successes. For example: “[Thirty] percent of adult SSI enrollees and 20 percent of the overall caseload in both counties were not aware that they had a choice of health plans under the waiver.” But that means that 70 and 80 percent presumably were aware they had choices. The article also seems to disregard the study’s own finding that “many reported that it was very easy or easy to get information about the various plan options.” Could part of the problem be that the survey was taken too soon, before people had information about their options? It takes time for people to learn about program changes and plan options, all of which were state approved. Certainly there are some ways in which the program can be improved, but giving people on Medicaid the dignity of having a choice of the private coverage is certainly worth trying.
Author response to Turner comment 14 November 2008
Terri Coughlin, Principal Research Associate Urban Institute, Sharon K. Long Send comment to journal: Re: Author response to Turner comment tcoughlin{at}urban.org Terri Coughlin, et al.	While Ms. Turner is correct that the telephone survey was conducted before everyone was required to enroll in reform, this paper is limited to a sample of Medicaid beneficiaries who the state reported as already having enrolled in Medicaid reform prior to the survey (see page 14 and Exhibit 1). These individuals were, thus, interviewed after enrollment had ostensibly taken place. But as shown in Exhibit 1, only about 62 percent of these beneficiaries were aware that they had been enrolled in reform.