September 21, 2016

Liz Dudek, top health care official, retires after 40 years with state


Liz Dudek, one of the longest-serving agency heads under Gov. Rick Scott, is retiring as secretary of the Agency for Health Care Administration, the governor's office announced Wednesday.

Dudek, who earns $141,000, is responsible for the agency that manages Medicaid in Florida. Her leave is official Oct. 3.

Deputy Secretary of Medicaid Justin Senior has been appointed interim secretary of the agency.

Dudek, of Tallahassee, has led AHCA since 2011 when Scott took office. But her tenure with the state reaches back more than 40 years.

"Under her leadership, we have worked to make hospitals more transparent and accomplished historic Medicaid reform," Scott said in a statement. "She helped champion quality health services for children in our state and worked hard on our Commission on Healthcare and Hospital Funding where she fought to protect patients from being price gouged at hospitals."

She previously was bureau chief of health facility compliance and assistant deputy secretary of managed care and health quality for AHCA.

Last year, after lawmakers reached stalemate over expanding Medicaid, Scott named Dudek the co-chairman of the Commission on Health Care and Hospital Funding.

Dudek's agency has been under scrutiny in recent years for its treatment of abortion clinics, and both she and Senior have been at the front lines of major political battles in the Florida Legislature over Medicaid expansion and health care reforms.

Still, even critics of the Scott administration's health care agenda laud Dudek's leadership.

"She was always really professional to work with," said House Democratic Leader Mark Pafford, D-West Palm Beach, CEO of pro-Medicaid expansion group Florida CHAIN. "There aren't very many people at all that I have tremendous respect for and admiration, but Liz is one of those few people."

Correction: An earlier version of this post incorrectly said AHCA is responsible for Medicare in Florida.

December 22, 2015

PAC ad highlights Marco Rubio's efforts to end Obamacare

A Super PAC supporting U.S. Sen. Marco Rubio released a TV ad today that highlights his efforts to end Obamacare.

The Conservative Solutions' ad will run on TV in Iowa and New Hampshire.

The ad states: "For all the Republican talk about dismantling the Affordable Care Act, one Republican presidential hopeful has actually done something…“Marco Rubio conceived and pushed a plan that will all but kill ObamaCare.”

It's not entirely clear from the ad, but it is a reference to Rubio's efforts last year related to something called "risk corridors" in the Affordable Care Act. In December, PolitiFact Florida fact-checked a tweet by Rubio who said "Last year, I stopped an Obamacare bailout and saved taxpayers $2.5 billion."

He was referring to risk corridors, which faced a $2.5 billion shortfall for 2014. Rubio, whose efforts to repeal risk corridors have so far failed, helped persuade Congress last year to prevent Health and Human Services from being able to cover the difference with money from its own budget. But experts said calling the program a bailout is not accurate and that he didn't necessarily save money in the long run. PolitiFact Florida rated his claim Mostly False.  


December 17, 2015

Miami health insurer blames layoffs on risk-corridor limits pushed by Marco Rubio

via @dchangmiami

A Coral Gables-based health insurance company and dozens of its employees are the latest casualties of a Republican-led legislative gambit in 2014 to undermine the Affordable Care Act — a maneuver for which presidential hopeful and U.S. Sen. Marco Rubio of Florida has taken credit on the campaign trail.

Preferred Medical Plan filed notice on Wednesday that the private insurance company intends to lay off 162 employees in February, according to the Florida Department of Economic Opportunity.

The company will remain in business, said James Card, a spokesman. But Preferred Medical will cover a much smaller number of Floridians — in large part because of a significant reduction in payments that the company expected to receive under the health law.

“Preferred Medical was prohibited from participating on the 2016 [ACA] exchange,” Card said in a written statement.

The reason: the federal Centers for Medicare and Medicaid Services or CMS could not pay the health insurer what was promised in 2010 under the so-called Risk Corridor program, a risk-sharing arrangement that Rubio calls a taxpayer “bailout” of insurance companies.

Following Wednesday’s release of an appropriations bill that includes a measure to once again restrict payments to insurers in 2016, Rubio issued a press release that read, in part: “ObamaCare’s bailout provision has nothing to do with helping people access health insurance, but it has everything to do with how big businesses in this country game big government to increase their profits, and how big government games big businesses to increase government’s reach into our lives.”

More here.

November 18, 2015

HHS secretary visits Miami to promote Obamacare

via @dchangmiami

With more than a million Floridians signed up for coverage through the Affordable Care Act’s insurance exchange — and nearly as many still uninsured but eligible for some type of plan in 2015 — Health and Human Services Secretary Sylvia Burwell visited Miami on Wednesday to make a hard sell for people to enroll.

She toured an enrollment center at Miami Dade College’s Wolfson Campus downtown, met privately with South Florida healthcare leaders and held a press conference where she introduced a Miami small business owner who pays $75 a month for coverage through the exchange.

Burwell also repeated slogans about the “affordability” of health plans sold on the exchange and trumpeted the “simplicity and ease” of enrollment with new user-friendly features, such as an “out-of-pocket cost estimator” tool that debuted this year on to help consumers estimate their plan deductibles, co-payments and other expenses.

About 1 million people nationwide — about one third of whom are new consumers — have selected a plan during the first two weeks of open enrollment, which began Nov. 1 and runs through Jan. 31, though people have to pick a plan by Dec. 15 to have coverage beginning on Jan. 1.

More here.

October 13, 2015

Jeb Bush to outline plan to replace Obamacare

via @learyreports

On Tuesday in New Hampshire, Jeb Bush will outline a plan to replace Obamacare.

Background from his campaign:

I. Promote innovation in health care

Health care costs grow faster than any other sector of the economy and innovation lags. Why? Washington over-regulation in health care creates high barriers to entry, adds excessive costs, fosters excessive complexity and impedes innovation. Governor Bush will:

• Modernize the Food and Drug Administration’s regulatory morass and increase funding and accountability at the National Institutes of Health

• Promote private sector leadership of health information technology adoption and enable better access to patient de-identified Medicare and Medicaid claims data

• Establish a comprehensive review of regulatory barriers to health innovation

Continue reading "Jeb Bush to outline plan to replace Obamacare" »

September 11, 2015

Kathy Castor asks feds to intervene in Florida's failure to cover poor and disabled kids

via @Marbinius

U.S. Rep. Kathy Castor is asking federal health administrators to investigate Florida’s “outrageous and miserable history” of denying adequate healthcare to impoverished and disabled children, saying the state has deliberately ignored a judge’s ruling that Florida’s insurer for the needy is systematically violating federal law.

In a letter Thursday, Castor called upon Sylvia Burwell, the secretary of the U.S. Department of Health and Human Services, to “exercise [her] oversight and enforcement authority to ensure Florida children receive the care required under the law.”

By sending the missive, Castor, a Tampa Democrat, is wading into a dispute between state health administrators and doctors for impoverished children that simmered for a decade before reaching a boiling point last year. On the last day of December 2014, U.S. Circuit Judge Adalberto Jordan declared Florida's healthcare system for needy and disabled children to be in violation of several federal laws. Jordan’s ruling was a milestone in a lawsuit by pediatricians and several families that had been filed 10 years earlier.

Florida’s spending for the healthcare of children in Medicaid, the state’s insurer for the needy, is so inadequate, Jordan wrote in a 153-page ruling, that most pediatricians and specialists have been driven from the program. As a consequence, the judge wrote, poor and disabled children often endure long waits for an appointment, or travel hours to a population center to see a doctor.

More here.

August 27, 2015

Florida regulator says Obamacare premiums will rise 9.5% in 2016

via @dchangmiami

Health insurance premiums for Floridians who buy their own plans will rise 9.5 percent on average for 2016, though some consumers will pay less for their coverage than they did this year, state insurance regulators reported Wednesday.

A total of 19 health insurance companies submitted rate filings to Florida’s Office of Insurance Regulation, which this year regained the authority to deny rate increases for health plans sold on the Affordable Care Act’s insurance exchange at

Average rate changes for 2016 plans sold on the ACA exchange will range from a decrease of nearly 10 percent for some plans, to an increase of as much as 16 percent for others.

Rate increases could have been higher, though, if not for the return of prior-approval authority for the Office of Insurance Regulation this year. A 2013 state law barred the state agency from regulating rates for ACA exchange plans, but that prohibition expired in March.

As a result, Florida regulators denied proposed rate increases for more than half of the issuers in the state for 2016. The majority of health plans received approval for single-digit increases, and four will decrease their rates from 2015.

More here.

August 24, 2015

Florida lawmakers featured in anti-Medicaid expansion ads

Several Tampa Bay area legislators are among those featured prominently in a new TV and digital ad by Americans for Prosperity, "thanking" them for blocking Medicaid expansion during the 2015 session.

AFP, a conservative advocacy group backed by the Koch brothers, says in a release that "the two-week long TV effort will feature TV, digital and mail to educate Floridians about the 72 legislators who stood up for taxpayers and patients against special interests who pushed to bring Obama’s Medicaid expansion to the Sunshine State."

AFP says five different versions of its 30-second ads are airing across Florida, including the one below.

July 09, 2015

Report: Health care costs remain shrouded in mystery in Florida -- and most states

via @dchangmiami

Consumers with health insurance shouldered more of the expense for their medical care in 2014, but Florida and nearly every other state did little to require that prices for hospitals and doctors be made public — hindering comparison shopping and allowing dominant hospital systems and insurers to drive up costs overall, according to a report released Wednesday.

Florida was among 45 states that received a failing grade for neglecting to adopt laws that give patients the data they need to plan for their healthcare expenses, according to the report produced by two nonprofit groups, Catalyst for Payment Reform in California and the Health Care Incentives Improvement Institute in Connecticut.

The report looked only at state actions regarding healthcare price transparency, and not at the increasing number of health insurance companies that offer their members online tools to estimate out-of-pocket costs for medical care, such as Cigna and UnitedHealthcare.

Free websites, such as Healthcare Bluebook and Fair Health, also offer some price information. But in many cases, data are limited or are restricted to members of specific health plans.

State legislative efforts, however, could help to create a uniform experience for all consumers, whether they have insurance or not, said Suzanne Delbanco, executive director of Catalyst for Payment Reform.

More here.

June 26, 2015

Burwell decision secures subsidies, but feud continues in Florida over health care

Gov. Rick Scott and the legislative opponents to the Affordable Care Act dodged a bullet Thursday when the U.S. Supreme Court upheld the federal health insurance subsidies, but it did little to narrow the divide between Republicans over how to handle Florida’s uninsured.

The ruling reduces the pressure on state leaders to create a state exchange to cover the 1.3 million low- and middle-income Floridians who now rely on the federal program for health insurance. But it leaves unanswered the question of how Florida will handle the loss of $400 million federal Low Income Pool money used to reimburse hospitals and health care providers who provide charity care to the uninsured.

After a bitter and divisive legislative session that led to a special budget session ending last week, lawmakers must return in January to craft a new budget for 2016-17 that addresses the loss of the LIP funds. The federal government confirmed this week that it would limit Florida’s LIP money to $1 billion to help cover the cost of the uninsured not covered under Obamacare, for the 2015-16 budget year. But it also said the state’s LIP money would be limited to only $600 million in 2016-17.

That has prompted Republicans in the Florida Senate to renew calls for the state to create an alternative, privately run plan to draw down federal money to cover an estimated 800,000 uninsured Floridians. Florida was among the 34 states that allowed the federal government to run the insurance marketplace, known as exchanges, that allow eligible Floridians to shop for individual health plans.

But thousands of low-income adults who would be eligible for Medicaid under expansion remain in the “coverage gap.”

Scott and the Republican leaders in the House opposed the Senate’s efforts to create the plan this year. They argued it would prop up a “broken” Medicaid system, expand the federal deficit and hurt taxpayers.

The issue deeply divided the two chambers, as Scott and House leaders accused several senators, including Senate President Andy Gardiner, R-Orlando, who works for an Orlando hospital, of using his office to advocate for his industry.

On Thursday, comment from both sides indicated the feuding is likely to continue.

More here.