Mary Mayhew, head of the Agency for Health Care Administration, says she expects changes at the $29-billion agency designed to help the state’s most vulnerable people.
“We can’t sit back and manage to the status quo or to become complacent about the approaches. I believe in a culture of continuous process and quality improvement. That can be uncomfortable,” Mayhew told lawmakers on the Senate Health Policy Committee.
“It is human nature often to defend what you have designed, the policies you have developed. But we will continue to look at ways in which to advance that mission and to hold ourselves accountable,” she says.
Mayhew expects to review the entire “spectrum” of the agency’s activities, ranging from providing health-care services to licensing and oversight roles.
She sparked controversy in Maine after serving some half-dozen years as the state’s commissioner of health and human services.
Advocates say she fought the expansion of Medicaid under the Affordable Care Act known as Obamacare and slashed food assistance and other safety-net programs for some of Maine’s sickest and poorest residents.
Mayhew appeared before Florida Senate committee members Monday but lawmakers didn’t pose questions at the time. But questions will come when Mayhew faces her formal Senate confirmation hearing.
Her answers could offer some insight into how Gov. Ron DeSantis’s policies will impact the lives of the 3.9 million Floridians who rely on Medicaid for their health-care coverage.
Mayhew is likely to continue to oppose Medicaid expansion – with support from DeSantis and Republican legislative leaders who have balked at expanding the state-federal health care program for the poor and disabled.
The resistance has come even though Florida ranks fifth in the nation in uninsured residents, with 2.7 million Floridians without coverage in 2017, according to the U.S. Census.
Another issue facing the state’s new Medicaid director will be the continued debate over whether some or all of Florida’s Medicaid spending should be done as a so-called block grant from the federal government.
The proposal would give the state more flexibility in spending the health-care dollars, but opponents fear it would result in a spending cap that would shortchange needy Floridians.
Mayhew also will be involved in a decision on whether to make permanent a $98 million Medicaid cut that occurred under former Gov. Rick Scott.
The cut eliminated a “retroactivity” provision that paid for health care services for Floridians before they were enrolled in Medicaid but were eligible for the coverage.
Lawmakers will have to vote to make the cut permanent this year or else the retroactivity provision will be renewed in July, according to federal officials.
Mayhew, who spent three months as the federal Medicaid director under President Donald Trump, says DeSantis “is committed to protecting the vital safety net provided by Medicaid.”
Her goal as the head of the Florida Agency for Health Care Administration is “to move the needle to support high-quality care efficiently delivered.”
“And that’s not just a phrase but that we have meaningful objective data to support it, that we are providing that access and creating that accountability throughout the system,” she says.
Mayhew adds that she’ll “go into greater detail” in the next few weeks when she returns to the Senate for her confirmation hearings.
Sen. Janet Cruz, a Tampa Democrat, says she was taking “a wait and see” approach with Mayhew.
“I will reserve my opinion of the work she is doing when she does the work,” Cruz says.
Cruz says she and the other Senate Democrats remain committed to trying to expand Medicaid in Florida, although that remains unlikely with the strong opposition from the Republican leadership.
On a brighter note, Cruz says she was “encouraged” by DeSantis’ budget health-care proposal, which did not contain any major Medicaid cuts.