April 01, 2015

Senator "encouraged" by talks with federal health officials

ReneState Sen. René García, R-Hialeah, left Washington Tuesday feeling "encouraged" by his conversations with federal health officials, he said.

He and Sen. Garrett Richter, R-Naples, made the last-minute trip at the request of Senate President Andy Gardiner

The two lawmakers met with representatives from the U.S. Centers for Medicare and Medicaid Services to discuss Florida's Low Income Pool program. The federal government has said it will not continue the $2.2 billion hospital funding program in its current form, blowing a sizable hole into the state health care budget.

García said he outlined a Senate proposal for a LIP replacement program, which would distribute the money more broadly than the current model does.

"I wanted to present our case as to why I think the LIP model that we have is something they can approve, and to try to get them to move on LIP so we can know what to do in the state of Florida as we go into budget conference," he said.

The feedback, he said, was "very positive."

García stressed the fact that the legislature has only a few more weeks to finalize Florida's budget, he said. 

"We can't do our budgets without them," García said.

The hour-long discussion also covered Medicaid expansion.

"There was a conversation on both [the LIP and Medicaid] fronts because in our budget, one is tied to another," García said. 

For the past three years, Florida has refused $51 billion in federal money earmarked for expanding subsidized health care coverage. The Senate is now advancing a plan to expand coverage through the use of a state-run marketplace for private insurance. But the House has refused to consider it.

Some observers have speculated that the federal government won't extend Florida's LIP program unless the legislature expands Medicaid. 

García said his plan was to send a clear message on both issues.

"We want CMS to know that the Senate is serious about the Low Income Pool and the issues around Medicaid and the plan that we have," he said.

García and Richter weren't the first Floridians to meet with CMS about the LIP program. The state Agency for Health Care Administration has spent the last several weeks trying to negotiate a successor program.

On Tuesday, Agency Secretary Liz Dudek said she was unaware the two senators were meeting with CMS. She said the agency had already presented the Senate proposal.

García said his trip was not meant supersede the those negotiations.

"We were not there to negotiate," he said. "All we were there to do was... let them know we are working on it and trying to find solutions."

March 31, 2015

Florida lawmakers travel to DC to talk health care

ReneWondering why Sens. René García, R-Hialeah, and Garrett Richter, R-Naples, aren't in Tallahassee today?

They are meeting with the U.S. Department of Health and Human Services.

The two lawmakers flew to Washington at the request of Senate President Andy Gardiner, spokeswoman Katie Betta said.

The purpose of the trip: to get a better idea of where Florida stands on some key health care issues.

"With tomorrow marking the halfway point of the session, we are nearing the time when the legislature is going to have to start finalizing decisions on the budget," Betta said.

Among the unresolved issues: what the future holds for Florida's Low Income Pool program.

The federal government has said it will not renew the $2.1 billion program, which helps hospitals treat uninsured and Medicaid patients, as it exists today. But the state and federal government have been unable to reach consensus on a successor program. 

The Senate recently recommended a new program would distribute the Low Income Pool funds more broadly than the original program. It was not clear how the idea was received by the U.S. Centers for Medicare and Medicaid Services.

The Senate has also been driving a push to expand health care coverage to nearly one million poor Floridians. That, too, would require approval from the federal government, assuming it passed through the resistant House.

Medicaid expansion supporters strike back

One day after a conservative advocacy group sent out mailers attacking the senators who support Medicaid expansion, a coalition of business leaders released a video thanking the Senate for its "bold leadership and courage."

The group, a Healthy Florida Works, was instrumental in drafting the Senate's plan to expand healthcare coverage to nearly one million poor Floridians.

"As highlighted in the coalition’s new video, the Senate's comprehensive health care package will save the state billions, create good paying jobs and provide health care coverage to more than 800,000 Floridians," the group said in Tuesday press release.

The video will be blasted out on social media and will run in certain TV markets.


March 30, 2015

Conservative group targets senators who voted for Medicaid expansion plan

The conservative advocacy group Americans for Prosperity Florida sent out mailers Monday targeting the 23 senators who have approved the proposed alternative to Medicaid expansion.

Among them: Sens. Rene Garcia, R-Hialeah; Anitere Flores, R-Miami; Oscar Braynon, D-Miami Gardens; and Gwen Margolis, D-Miami.

"We are reaching out to Floridians in every district of every member of the Senate that has taken a vote in favor of expanding the broken and bloated Medicaid system under Obamacare," AFP state director Chris Hudson said in a statement.

The mail piece also went to residents of Senate President Andy Gardiner's central Florida district.

The Senate has been advancing plan to use federal money to extend healthcare coverage to nearly one million low-income Floridians. The proposal is not Medicaid expansion as envisioned under the Affordable Care Act. Instead, it would require Florida create a state-run marketplace for private health insurance. What's more, beneficiaries would have to pay small monthly premiums and meet a work requirement.

Still, House Speaker Steve Crisafulli, R-Merritt Island, has said he isn't interested.

Gardiner said he agreed with AFP that "Florida should not expand the existing Medicaid program."  

"What we have done instead is to develop a consumer-driven approach that provides access to high-quality, affordable health care coverage while promoting personal responsibility," he said in a statement. "Our plan includes conservative, free market guardrails that will control the cost and growth of the Medicaid program for Florida’s taxpayers." 

Still, state director Hudson said the Senate would be better off focusing on the overall cost of health care.

"We have been advocating for expanding telemedicine, reforming certificate of need, and expanding scope of practice as some of the possible ways the Senate can take bold steps to making health care more affordable and available to all Floridians," he said.

March 20, 2015

Obamacare turns 5: What came true and what didn't

Predictions about the health care law were a dime a dozen back in 2010. Supporters contended that virtually everyone around the country would soon have access to affordable insurance. Opponents said the law would cost a fortune by adding to the national debt and killing jobs.

Actually, none of those things have happened.

As the Affordable Care Act makes its way to its fifth anniversary on Monday, the law has taken twists and turns, moving off course from where everyone thought it would be.

Once expected to insure 32 million new Americans by the end of the decade, the projected target has been downgraded to 27 million — far from the universal coverage many proponents hoped for.

Unforeseen developments, like significant changes in health cost trends and a sweeping Supreme Court decision on Medicaid expansion, have meant the insurance provisions in the law will cost $139 billion less over the next five years than it was supposed to back in 2010. That has quieted some critics who expected massive, deficit-inflating costs.

In five years, the law has steadily navigated toward its overall goal of decreasing the number of uninsured Americans, without dramatically disrupting the overall health care industry, for better or worse. Yet.

"The whole thing has been in much slower motion that what was predicted," said Michael Tanner, health care analyst with the libertarian Cato Institute. "Whether you thought something good was going to happen or something bad, you sort of thought it would have happened by now. Instead, it’s just been creeping along."

For the rest of the article by Angie Drobnic Holan and Steve Contorno, check out PolitiFact.

March 19, 2015

House, Senate clash on healthcare budget

The Florida House and Senate rolled out vastly different healthcare spending plans this week, putting the two chambers on a collision course over the state budget.

The proposals are $5 billion apart — more than the entire budget for the state of Vermont.

The Senate version includes $2.8 billion in federal money to pay for expanded healthcare coverage, something the House adamantly opposes. It also includes a $2.2 billion program known as the Low Income Pool that helps hospitals treat uninsured, under-insured and Medicaid patients.

Reaching consensus on the two issues will be difficult, and could require an extended or special legislative session. For now, leaders in both chambers are holding firm.

"Those are the Senate's priorities," Senate Health Appropriations Subcommittee Chairman René García said Thursday.

Building the healthcare budget is more complicated than usual this year, in part because the LIP program is set to end on June 30. The federal government has said it may be willing to approve a replacement program, but the negotiations are ongoing.

There’s also the issue of Medicaid expansion, a provision of the Affordable Care Act.

Continue reading "House, Senate clash on healthcare budget" »

March 17, 2015

Alternative to Medicaid expansion moves swiftly through the Florida Senate

A second Senate panel on Tuesday approved a proposal to extend federally-subsidized healthcare coverage to nearly one million poor residents.

The plan -- known as the Florida Health Insurance Affordability Exchange Program, or FHIX -- would create a state-run private health insurance marketplace. Participants would have to pay small monthly premiums and meet a work requirement.

Several members of the public spoke out against the bill Tuesday, including Bill Herrle of the National Federation of Independent Business.

"Business owners are very concerned for the future of this state when we become attendant to the whims of federal agencies," he said.

Other speakers voiced concerns about the work requirement and monthly premiums.

But by and large, representatives from hospitals, the business community and consumer advocacy groups gave their support.

"Extending healthcare coverage will benefit every Florida family, including those in our Hispanic community, and it will help Florida businesses," said President of the Florida State Hispanic Chamber of Commerce Julio Fuentes.

Members of the Senate Health and Human Services Appropriations Subcommittee agreed, approving the bill by a unanimous vote.

"This is no longer a Republican or a Democratic issue," said Senate Health and Human Services Appropriations Subcommittee Chairman Rene Garcia, R-Hialeah. "Are there issues with the Affordable Care Act? Absolutely... But to deny the hardworking men and women of this state access to health care, to me, is completely irresponsible."

The panel put the pressure on the House, which has opposed expanding Medicaid as envisioned under the Affordable Care Act.

"It's time that the House takes up the bill, looks out for Floridians, stops dealing in talking points and moves on," said Sen. Joseph Abruzzo, D-Wellington.

When asked if he believed the House would consider the plan, Senate Health Policy Committee Chairman Aaron Bean turned to baseball.

"It's the third inning of a nine-inning ball game," Bean said. "I'm looking for some big play in a latter inning for us to score on this issue. It's early."

March 11, 2015

League of Women Voters pushes alternative to Medicaid expansion


In the latest update to the Florida Medicaid expansion debate, the League of Women Voters in Florida held a call Wednesday afternoon supporting the recent passage of a proposal in the Florida Senate that hopes to expand coverage to about 800,000 uninsured Floridians.

The League’s president, Deirdre Macnab, said she was encouraged by the passage of the bill in the Senate and is hopeful it will also go on to pass in the more conservative Florida House.

"We've also been very encouraged by the really huge response by the business sector," Macnab said, referring to the support from several local-level chambers of commerce, business organizations and business lobbying group Associated Industries of Florida.

Continue reading "League of Women Voters pushes alternative to Medicaid expansion" »

March 10, 2015

Florida Senate panel pushes Medicaid expansion forward, but still a long shot

A state Senate panel on Tuesday approved a sweeping proposal that would allow Florida to use billions of federal dollars to expand healthcare coverage to about 800,000 low-income residents — if it’s able to overcome two big hurdles.

The bill (SPB 7044) won the unanimous support of the Senate Health Policy Committee and applause from the audience when it passed.

"It's a watershed day in the Florida Senate and, hopefully, in the Florida Legislature,” said Senate Democratic Leader Arthenia Joyner, D-Tampa.

The bill remains a long shot. Even with the support of the, influential Associated Industries of Florida and various hospital groups, it is unlikely to be considered by the more conservative Florida House.

"They’re going to have conversations that we probably won’t be having over here," House Speaker Steve Crisafulli said Tuesday.

The federal government is another potential stumbling block. The U.S. Centers for Medicare and Medicaid Services, a federal regulatory agency, would have to grant Florida a waiver in order for the state to get the federal funding. And some components in the Senate proposal have been rejected in other states.

As Senate Health Policy Chairman Aaron Bean, R-Fernandina Beach, acknowledged that the Senate plan has a "snowball’s chance" of winning support from both the House and the federal government.

"But you know what?" Bean said. "There’s a chance to open a dialogue and say what we have to do go forward. I look forward to the conversation."

More here.

Economists adjust predictions of an Obamacare disaster

It’s kinda scary how accurate state economists were in projecting revenues for next year’s budget. When they met Tuesday, they adjusted their general revenue forecasts by a mere 0.5 percent from December.

But one area they were a bit off was estimating the insurance premium tax. On Tuesday, economists acknowledged that they reduced the amount of revenue the tax will bring in this year by $82.8 million and another $41.3 million in next year’s budget.

And who can blame them from anticipating such fat revenue from the insurance premium tax?

Remember all the speculation and anecdotes about runaway insurance premiums once the Affordable Care Act was implemented? There was CNN Money, in a widely-circulated 2013 piece, predicting that Florida’s premiums would skyrocket 35 percent. Florida Blue, the state’s largest carrier, announced last year it was increasing its rates by 17.4 percent. The Republican Party of Florida ran an ad last year that predicted premiums were going to jump by as much as 30 percent. When pressed by PolitiFact (which found the ad’s claim “mostly false”), party officials cited a Morgan Stanley survey that showed Florida was seeing a 37 percent increase in individual plans and a 21 percent increase in small group plans.

No wonder they estimated such a spike in tax revenues.

But as state chief economist Amy Baker explained Tuesday, forecasters overestimated just how high the premiums would go. On Tuesday, they made the necessary corrections to their corresponding tax revenues.

“We’re assuming a little bit cheaper policy prices than what we originally anticipated when we put our estimate together,” Baker said. “There’s some more behavioral changes than we originally thought would exist. We did see some shifting of individuals who had policies go over into the marketplace to find something that’s more affordable for them. We did see some shifting among very small businesses that felt like (ACA) was offering a better option for their employees than what they could offer through their business. So some of those behavioral changes we weren’t anticipating, and it did bring down the estimate (of what the state was anticipating to collect) we had associated with that originally. We’re just now starting to see the first bits of data.”

So at least for now, Obamacare isn’t leading to skyrocketing premiums in Florida. SCOTUS permitting, plan accordingly.