House responds with batch of bills it says will lower health care costs

After spending the last legislative session knocking down Senate proposals for expanding health care coverage while offering no alternative of their own, Florida House Republicans filed a series of bills Wednesday that attempt to take a rifle-shot approach to lowering the spiraling costs of health care in Florida.

Many of the proposals are not new, and some have been passed by key committees in the state Senate, but all embrace the belief of many House leaders that the state must inject free-market competition into the health care marketplace to lower costs of health care before expanding access to the uninsured. Opponents, however, claim that many of the proposals just unleash turf battles within the health care industry that will not suppress costs.

“The crisis in health care begins at the cost part of that equation,’’ said Rep. Jose Oliva, R-Miami, a top House lieutenant. “Until we address costs there will never be enough [Medicaid] expansion as those costs continue to rise. What I need to do is put together a system that is heavily dependent on competition and consumerism and free markets.”

The bills, filed along with several budget bills that will be introduced in the three-week special session that begins Monday, include:

• HB 27A -- Expands the drug-prescribing powers of advanced-registered nurse practitioners and physician assistants. Filed by by Rep. Cary Pigman, R-AvonPark, who is a physician, supporters argue this will help to expand access to care, particularly in rural areas, by allowing health plans to bypass expensive doctors for routine patient visits. The measure is vigorously opposed, however, by the Florida Medical Association, which represents doctors and argues nurse practitioners and physician assistants don't have the training as doctors.
• HB 31A – Eliminates the state regulation known as "certificate of need" which requires that hospitals get state approval to build new or expand high-cost facilities such as trauma centers, neo-natal wards and other specialty services. The measure was filed by House Health & Human Services Chairman Jason Brodeur, R-Sanford, and is it expected to draw intense opposition from many in the hospital industry.
• HB 23A – Allows ambulatory surgical centers to keep patients overnight and pave the way for "recovery care centers" that could keep post-surgical patients for up to 72 hours. The measure was filed by Rep. Heather Fitzenhagen, R-Fort Myers, but is also opposed by hospital officials who fear that revenues from profitable services will be diverted from their base business.
• HB 21A – Would require that state employees choose from four different health insurance plans beginning in 2018 and use incentives to encourage people to choose the lower-cost plans.

Senate President Andy Gardiner, R-Orlando, told reporters this week that he was open to considering all of the bills passed by the House but considered them “second tier” to the Senate’s focus on expanding health insurance to the uninsured. 

“Those are all important issues,’’ he said. “Costs are important and we need to address that but we, in the Senate, have always been focused on the uninsured piece,’’ Gardiner said. “Some of these other issues are maybe worthy issues and if they make it through the Senate floor, we’ll vote it out.”

The News Service of Florida contributed to this report. 

• HB 27A -- Expands the drug-prescribing powers of advanced-registered nurse practitioners and physician assistants. Filed by by Rep. Cary Pigman, R-AvonPark, who is a physician, supporters argue this will help to expand access to care, particularly in rural areas, by allowing health plans to bypass expensive doctors for routine patient visits. The measure is vigorously opposed, however, by the Florida Medical Association, which represents doctors and argues nurse practitioners and physician assistants don't have the training as doctors.
• HB 31A – Eliminates the state regulation known as "certificate of need" which requires that hospitals get state approval to build new or expand high-cost facilities such as trauma centers, neo-natal wards and other specialty services. The measure was filed by House Health & Human Services Chairman Jason Brodeur, R-Sanford, and is it expected to draw intense opposition from many in the hospital industry.
• HB 23A – Allows ambulatory surgical centers to keep patients overnight and pave the way for "recovery care centers" that could keep post-surgical patients for up to 72 hours. The measure was filed by Rep. Heather Fitzenhagen, R-Fort Myers, but is also opposed by hospital officials who fear that revenues from profitable services will be diverted from their base business.
• HB 21A – Would require that state employees choose from four different health insurance plans beginning in 2018 and use incentives to encourage people to choose the lower-cost plans.

Senate President Andy Gardiner, R-Orlando, told reporters this week that he was open to considering all of the bills passed by the House but considered them “second tier” to the Senate’s focus on expanding health insurance to the uninsured. 

“Those are all important issues,’’ he said. “Costs are important and we need to address that but we, in the Senate, have always been focused on the uninsured piece,’’ Gardiner said. “Some of these other issues are maybe worthy issues and if they make it through the Senate floor, we’ll vote it out.”

The News Service of Florida contributed to this report.