June 23, 2015

What Jeb Bush said in Miami this month about SCOTUS and Obamacare


When he spoke to reporters in Miami on June 5, Jeb Bush was asked what government should do if the U.S. Supreme Court rules subsidies for the Affordable Care Act unconstitutional (a decision is due by Monday).

Here's what Bush said:

I think Congress ought to proactively unite behind an alternative to the status quo that would allow for a continuation -- as proposed, for example, by Sen. [Ron] Johnson [R-Wisconsin], or a variation of that -- where we would extend this out so there's not big disruption. But also give states the power to change Obamacare. In Florida it might mean less mandates -- no employer mandate, no employee mandate -- a high-deductible, lower-cost insurance that’s focused on catastrophic coverage in an exchange that's not coercive. So I think this is the opportunity for Republicans to not just talk about how bad Obamacare is -- which it is -- but also to unite behind an alternative. And Congress would have to do this. If not, the governor is stuck, and the Legislature is stuck, in a precarious position.

June 17, 2015

Gov. Rick Scott won't drop lawsuit against feds until decision made on LIP


A federal court hearing that could have featured testimony from Florida Gov. Rick Scott and U.S. Health and Human Services Sec. Sylvia Burwell was canceled today after Gov. Scott withdrew his request that the judge in the case compel the government to continue a hospital payment program set to expire on June 30.

Judge M. Casey Rodgers issued the order today canceling the hearing previously set for Friday, and she ordered the federal government to file a response by July 8 to Gov. Scott's legal complaint that the Obama administration was attempting to coerce Florida to adopt Medicaid expansion by withholding a decision on the hospital payment program known as Low Income Pool.

In a legal brief filed Wednesday, Gov. Scott stated that the Florida Legislature's budget agreement assumes LIP funding will continue and that the proposal sets aside sufficient funds to pay state hospitals that care for large numbers of uninsured and under-insured  patients on Medicaid.

"The budget agreement thus mitigates the threat of imminent harm to the State, its healthcare providers, and their patients,'' the legal brief states.

Continue reading "Gov. Rick Scott won't drop lawsuit against feds until decision made on LIP" »

June 15, 2015

Remember those House bills on healthcare cost? Senate says never mind, let's study it

The Florida House's attempt to get the state Senate to focus on passing legislation aimed at controlling health care costs is now getting the same treatment as the Senate's to expand health insurance with Medicaid money -- it's dead.

Sen. Aaron Bean, R-Fernandina Beach, chairman of the Senate Committee on Health Policy on Monday cancelled Tuesday’s scheduled meeting of his committee to take up six bills that have passed the House and instead released a statement calling for a joint House and Senate "Task Force on Health Care Policy Innovation."

“Last week, our committee held a workshop where we reviewed and discussed several pieces of legislation designed to expand access, increase competition and lower the cost of health care services in our state,'' he said in a statement. "In one form or another some of these policy ideas have previously earned support in the Senate, while others are new and have not yet been fully explored."

The House last week passed six bills that said would contain health care costs and the Senate last week held a workshop on some of the ideas. The bills stripped away regulations by eliminating the certificate of need for hospital expansion, opened the door to off-site surgery and recovery centers, allowed advanced-registered nurse practitioners and physician assistants to prescribe controlled substances, and created new options for state employees to choose from health-insurance plans.

Continue reading "Remember those House bills on healthcare cost? Senate says never mind, let's study it" »

June 14, 2015

No back-up plan in Florida if SCOTUS guts Obamacare subsidies

via @dchangmiami

There is no official plan. There is no time to execute one, even if there were a plan. And, perhaps most importantly, there appears to be no political leadership in Florida to act if the Supreme Court rules this month that more than 6 million Americans, including about 1.3 million Florida residents, can no longer receive federal subsidies that help pay for their health insurance under the Affordable Care Act, according to health policy experts.

Many scenarios could play out if the Supreme Court rules that billions of dollars in health insurance subsidies, including an estimated $389 million a month for Florida residents, can only be distributed through exchanges established by a state, as the plaintiffs argue in King v. Burwell.

But absent a ruling that provides for a temporary extension of subsidies for residents of the 34 states that rely entirely on the federal exchange at HealthCare.gov, health policy analysts say any long-term solution comes down to state action — or Congress.

“There aren’t a lot of fallback options in place at this time," said Cynthia Cox, associate director of health reform and private insurance for the Kaiser Family Foundation, a California-based health policy research nonprofit group.

In Florida, legislators have no official plan — though conversations have been taking place — and they likely will look to the federal government first for a solution if the Supreme Court rules for the challengers, said Diane Hilligoss, a University of Michigan law student and researcher who interviewed Florida lawmakers and others in the spring for a study published by Health Affairs, a health policy journal.

More here.

June 10, 2015

Judge denies Gov. Scott's request for mediation over LIP program


A federal judge on Wednesday denied a request from Gov. Rick Scott that the court intervene in the state’s ongoing negotiations with healthcare regulators over the extension and revamping of a $1 billion government program that pays hospitals for caring for uninsured and under-insured patients.

In denying Gov. Scott’s request, Chief Judge for the U.S. District Court in Pensacola M. Casey Rodgers cited a June 19 hearing in the state's lawsuit against the U.S. Department of Health and Human Services that will require “extensive preparation on the part of all parties.’’

If the court were to compel mediation in the federal-state negotiations over the hospital payment program known as the Low Income Pool or LIP, then such an order “would be unduly burdensome, expensive, and not likely to advance the process any faster than the expected proceeding currently scheduled,’’ Rodgers wrote.

Gov. Scott issued a written statement following the judge's order, lamenting what he has repeatedly alleged are coercive tactics by the federal government to pressure Florida to adopt Medicaid expansion. 

Continue reading "Judge denies Gov. Scott's request for mediation over LIP program" »

June 09, 2015

Gov. Rick Scott, and HCA, back House effort to deregulate hospital expansion

Gov. Rick Scott joined with House leaders and his former company Tuesday and put his support behind a plan to eliminate the controversial law that requires state approval for the building of new hospitals.

“Driving down healthcare costs is essential to expanding access to coverage and increasing quality,'' Scott said in a statement.

The House Health Innovation Subcommittee voted 9-3 along party lines to eliminate the so-called "certificate of need" process that requires state regulators to review and approve the construction of any new hospitals, the replacement of existing hospitals, or the development of certain expansive medical services such as organ transplants.

"When you have a free market, you get a better product at a lower cost and that’s going to help the access,’’ said Rep. Jason Brodeur, R-Sanford, sponsor of the bill.

Opponents, including the Florida Hospitals Association, warned however, that removing the regulation would discourage hospitals from building and expanding in poor areas, resulting in health care deserts as hospitals concentrate in affluent neighborhoods.

Continue reading "Gov. Rick Scott, and HCA, back House effort to deregulate hospital expansion " »

June 06, 2015

House members reject entitlements for others, but enjoy taxpayer-paid health plan themselves

IMG_4830One of the chief arguments Florida House Republicans made Friday when they rejected the Senate plan to help 600,000 working poor get health insurance is that it would create a taxpayer-funded entitlement and would be hard to repeal.

What they didn’t mention during the debate is that they are entitled to a very generous health insurance package that costs $22,000 a year — with premiums mostly covered by Florida taxpayers. And, over the years, they have rejected any attempts by Gov. Rick Scott to reduce the benefit.

For many of the 160 members of the Florida House and Senate, the prospect of having to scramble for cash to pay for medication and doctor visits is not something that keeps them up at night. According to financial disclosure statements, 54 legislators are millionaires and 145 of them are enrolled in the taxpayer-financed State Group Health insurance plan, which includes about 80,000 full-time state workers.

The monthly cost per legislator: $180 a month for a family, or $2,160 a year, and $50 a month, or $600 a year for individuals. That’s only a fraction of the average monthly family premium paid by most Floridians — $1,347 — according to data tabulated by the Kaiser Family Foundation.

Until last year, House members were part of a group of state workers who got an even better deal: $30 a month for family health insurance coverage, and $8.34 a month for individuals. That group, along with 800 legislative staff, the governor and his Cabinet are among about 17,500 state workers, known as the Senior Management and Select Exempt Service, who pay the lowest costs in the state.

More here

Photo: House Appropriations Chairman Richard Corcoran and House Speaker Steve Crisafulli listening to House presentation on Senate health insurance bill Monday. Photo by Mary Ellen Klas

June 04, 2015

Questions and questions: a healthy sampling of 67 of them on health insurance

Rep. Mia Jones, D-Jacksonville, received kudos as she answered questions on the Senate health insurance expansion plan, SB 2-A, from both Democrats and Republicans, for more than 2.5 hours Thursday. 

Here's an abbreviated version of the top 67 questions, followed by Jones' answers: 

Continue reading "Questions and questions: a healthy sampling of 67 of them on health insurance " »

Dueling facts sheets emerge over health insurance debate

We're counting questions asked of Rep. Mia Jones, D-Jacksonville, tasked with defending the Senate Republican's health insurance plan on the floor of the House today, and she's answered at least 50 at this point.

Meanwhile, each chamber released a set of fact sheets explaining their case.

Here is Senate fact sheet: Download Senate facts on FHIX 

Here are House's:  Download FHIX 3.0 Senate Amendment Summary  Download New Fiscal Analysis for FHIX 3.0 (1)

White House economists say that expanding insurance in Florida will save 900 lives

via @dchangmiami

The Obama administration weighed in on Florida’s legislative debate over Medicaid expansion Thursday with an updated version of a report from the White House Council of Economic Advisers, first released in summer 2014 and updated for this year, counting the ways the Sunshine State would gain by opening eligibility for the government healthcare program to nearly all low-income adults.

Most of the projected gains have been trumpeted before: billions of dollars in federal funding and fewer people uninsured or facing medical debt. But, in a reflection of how intense the debate has become, the state-by-state report adds a new measure this year: fewer deaths.

If the 22 states that have not yet expanded Medicaid did so, the report states, 5,200 deaths would be avoided each year. In Florida, the report estimates, 900 fewer people would die each year once coverage was fully in effect.

Washington, D.C., and the 28 states that have already expanded Medicaid will avoid 5,000 deaths per year, according to the report, which derived the estimates from various studies, including two that looked at mortality and access to care after state Medicaid expansions.

The White House released the report, titled Missed Opportunities, just as Florida’s Senate gave bi-partisan approval to a plan that expands Medicaid by drawing federal money into a privately run program to provide subsidized health insurance to low-income, working Floridians.

More here.