Florida's Agency for Health Care Administration may broaden the state's Medicaid-reform pilot program to include 19 more counties including Palm Beach and Miami-Dade counties, to save more than $58 million by requiring Medicaid beneficiaries enroll in managed-care plans.

Expanding the pilot program would help reduce fraud and hold down spiraling Medicaid costs, but at the same time, Florida Medicaid program faces other obstacles, including a class-action Medicaid lawsuit.

Bill Persinger, Executive Director of the Mental Health Center, said the 10% cuts in Medicaid handed down at the state level have affected the center greatly.

"We believe it does slow the growth of expenditures", Secretary of the Agency for Health Care Administration, Tom Arnold said.

The spending for the aged and disabled fell, while spending for women and children rose a bit.

But critics of the reform said it should be dropped and not expanded as some patients and advocates have long complained that it's hard to find doctors who accept HMOs in reform.

"The problems of managed care are amplified in Medicaid reform", said Greg Mellowe, Policy Director for Florida CHAIN.

The survey by more than 120 doctors found that 58-77% people stated that the reform was not working very well in areas like access to specialists, access to drugs, patient satisfaction and overall access to care.