News from Tallahassee for 7/1/15

Winners and losers of the Florida Legislature’s special session posted on 6/22/15

by palm beach post

FL Capitol rotundaWorking into June on a state budget for the first time in 23 years, Florida lawmakers avoided a government shutdown by approving a $78.7 billion spending plan Friday evening.

But the long battle left a few bruises.

Gov. Rick Scott and legislative leaders didn’t get all they wanted. Talk back in March of almost $700 million in tax breaks got downsized amid a long fight over the Senate’s unsuccessful push to expand health coverage for the uninsured.

And the special session that started June 1 after the regular 60-day legislative session ended without a budget will cost taxpayers.

The cost of the extra 19 days of legislating? It’s still being calculated. But history shows taxpayers will pony up anywhere from $24,000- to $87,000-a-day, or in other words probably somewhere in the $500,000-$1.5 million range.

Scott is now reviewing the budget. He’s expected to sign it, while issuing a round of line-item vetoes before this year’s budget expires July 1.

How did some of the top players, and special interests, fare? Take a look inside.

Study: 19 Million Uninsured If Law Repealed posted on 6/22/15

by phil galewitz | kaiser health news

Repealing the federal health law would add an additional 19 million to the ranks of the uninsured in 2016 and increase the federal deficit over the next decade, the Congressional Budget Office said Friday.

The report is the first time CBO has analyzed the costs of the health law using a format favored by congressional Republicans that factors in the effects on the overall economy. It is also the agency’s first analysis on the law under Keith Hall, the new CBO director appointed by Republicans earlier this year.

CBO projected that a repeal would increase the federal deficit by $353 billion over 10 years because of higher direct federal spending on health programs such as Medicare and lower revenues.

But when including the broader effects of a repeal on the economy, including slightly higher employment, it estimated that the federal deficit would increase by $137 billion instead.

Both estimates are higher than in 2012, the last time that the CBO scored the cost of a repeal.

The latest report from the nonpartisan congressional watchdog and the Congressional Joint Committee on Taxation comes just days before the Supreme Court is expected to rule on the health law’s premium subsidies in the nearly three dozen states that rely on the federal marketplace.

Such a ruling would cut off subsides to more than 6 million people and be a major blow to the Affordable Care Act. It could also boost Republican efforts to repeal the entire 2010 law, which would likely face a presidential veto.

Last week, President Barack Obama said nearly one in three uninsured Americans have been covered by the law—more than 16 million people.

» Read more

Senate won’t hear House’s health bills; proposes task force instead posted on 6/16/15

by john kennedy | Palm Beach Post

The House’s half-dozen bills aimed at easing regulations on hospital expansion and other health care issues will not be going before a Senate committee, the panel’s chairman said Monday.

Senate Health Policy Chief Aaron Bean, R-Fernandina Beach, said he didn’t think the Legislature’s 20-day special session was an appropriate venue for considering the sweeping changes proposed by the House.

Instead, Bean said he wants a House-Senate task force formed to study the issues and more in coming months.

“I believe this approach will provide the opportunity for the House and Senate to debate, discuss and take public testimony on comprehensive short and long term solutions to Florida’s health care challenges,” Bean said.

Bean’s committee last week held a workshop on proposals to eliminate certificate of need requirements for hospitals looking to expand or open new facilities, another measure that would let nurses and physicians’ assistants prescribe certain medications, and other steps House leaders say will reduce the cost of health care.

The legislation sailed through the House days after the chamber killed the Senate’s proposed Florida Health Insurance Exchange (FHIX), a privatized form of Medicaid expansion.

Despite the snub on FHIX, Senate President Andy Gardiner, R-Orlando, said his side was open to hearing the House’s proposals.

Now, that isn’t going to happen.

» Read more

House Lines Up Potential Healthcare Changes posted on 6/11/15

by JIM SAUNDERS | NEWS SERVICE OF FLORIDA

After rejecting a controversial expansion of health coverage for low-income Floridians, House Republicans took a far-different approach Wednesday to revamping the state's health-care system.

A GOP-led committee approved six bills largely aimed at stripping away regulations, offering new ways for patients to get care and nudging state employees to pick from a menu of health-insurance plans.

House leaders say they want to create more competition and choices for consumers, which they contend will hold down costs and provide more access to care.

As an example, one of the bills (HB 23A) would allow patients to stay at ambulatory-surgical centers for up to 24 hours, eliminating a regulation that currently prevents overnight stays. Also, the bill would allow the creation of "recovery care centers," where patients could stay for up to 72 hours after surgery.

"I think this is a step in our overall desire to be able to offer better health care to Floridians, offer more transparency in the delivery of services and make it a much more competitive, safe marketplace," said bill sponsor Heather Fitzenhagen, R-Fort Myers.

But while the House Health & Human Services Committee overwhelmingly approved the bills, Democratic lawmakers raised questions about how some of the proposed changes would affect hospitals and low-income patients.

One of the most heavily debated bills (HB 31A) would eliminate what is known as the hospital "certificate of need" process, which regulates construction and replacement of hospitals and the offering of certain complex, costly procedures. Democratic lawmakers and the Florida Hospital Association expressed concerns that the bill would lead to new hospitals siphoning off insured patients, leaving behind other hospitals to treat uninsured patients and to provide services such as burn units.

» Read more

Judge rejects mediation in health-care funding dispute posted on 6/11/15

by News Service of Florida

TALLAHASSEE -- A federal judge Wednesday rejected a request by Gov. Rick Scott for mediation in a legal battle between the state and federal government about health-care funding.

Chief U.S. District Judge M. Casey Rodgers issued an order that said she has already scheduled a hearing next week on a Scott motion for a preliminary injunction in the case. "The hearing is scheduled for June 19, 2015, and will require extensive preparation on the part of all parties,'' Rodgers wrote. "Requiring them, on even shorter notice, to also attend court-ordered mediation, which is not guaranteed to result in any resolution of this case, would be unduly burdensome, expensive, and not likely to advance the process any faster than the expedited proceeding currently scheduled."

Scott filed the lawsuit in April, contending that the Obama administration was trying to unconstitutionally link continuation of the state's Low Income Pool health-funding program with expansion of Medicaid. The federal government has called those arguments "baseless" and has indicated that the state will receive about $1 billion in Low Income Pool funding for the fiscal year that starts July 1.

While the $1 billion is a reduction from the current year's funding for the so-called LIP program, state lawmakers are using that number as they negotiate a budget during an ongoing special session.

» Read more

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