News from Tallahassee for 7/30/15

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.

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Florida budget woes leave Scott's agenda in tatters posted on 6/9/15

by GARY FINEOUT | AP

FL Gov Rick scottTALLAHASSEE, Fla. (AP) -- Florida Gov. Rick Scott, narrowly re-elected just seven months ago, is discovering that the ongoing budget fight among members of his own party is leaving his own agenda in tatters.

The Republican-controlled Legislature is in the middle of a contentious special session to pass a new state budget. A deep divide between the House and Senate over health care prevented the two sides from enacting a spending plan during the regular session that ended in late April.

During his re-election campaign - and again earlier this year - Scott called on legislators to use a projected budget surplus to enact large tax cuts, boost school spending to historic levels and change state laws to make textbooks and graduate school tuition cheaper.

But the surplus has largely vanished amid a tug-of-war over health care. Senate leaders pushed to steer money away from tax cuts to help replace federal aid for hospitals that is being lost this summer.

Scott, who is suing the federal government over the loss of the aid, had maintained that there was a way to change the state's hospital funding formulas that would have preserved state money for other items. But his plan has been rejected because it would have resulted in millions in cuts to some of the state's largest public hospitals in metro areas such as Miami.

Scott, who promised voters to cut taxes by more than $1 billion over two years, asked for nearly $700 million in cuts during the first year of his new term. House Republicans have scaled it back to just under $300 million, although they have proposed additional cuts that would increase the size of cut by another $100 million in the second year. They have reduced the size of a cellphone tax cut pushed by Scott from roughly $43 a year to $10 a year. The House also jettisoned a proposal to exempt college textbooks from sales taxes; in its place, legislators proposed to waive the taxes during three days over the next year.

House and Senate budget negotiators have also proposed a 3 percent boost in per-pupil funding. That increase, however, would fall short of the record level promised by Scott. The governor is also having trouble winning support for a proposal to set aside $85 million for incentives to attract new companies to the state.

Scott angered Senate Republicans when he switched his position from two years ago and came out against their proposal to expand health care coverage. But Sen. Tom Lee, a Brandon Republican and Senate budget chief, maintained "this isn't personal."

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House Blasts, Then Kills, Medicaid Expansion posted on 6/8/15

by jim ash | wfsu

Medicaid expansion, the issue that caused this week’s special session, has flat lined. Now that the House and Senate have agreed to disagree, it’s up to the U.S. Supreme Court to decide whether 1.8 million Floridians go without health insurance.

Supporters of Medicaid expansion had twin goals – lower the state’s uninsured population and collect $1 billion federal health care dollars.

But Senate Republicans couldn’t get past a buzz saw of conservative opposition to federal entitlement programs. Here’s how health care chairman Jason Brodeur, a Sanford Republican, describes it.

“I think what you’re finding on this side of the Capitol, and particularly the Republican Party in general, is the disagreement with the premise that we need more government programming on top of what we already have.”

And here’s how Representative Paul Renner, a Palm Coast Republican, describes it.

“The taxpayers in the state of Florida will have a hook in their mouth for years to come. And it’s simply unaffordable. Medicaid, currently, the existing population, is growing so fast, it’s crowding out all of the other priorities. Priorities that we care about, public safety, education, infrastructure.”

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House Rejects FHIX By 72-41 Vote posted on 6/8/15

by AP

The Florida House has soundly rejected a Medicaid expansion compromise that even supporters admitted had its flaws and was seemingly doomed to fail almost from the start.

The bill, which tore apart the regular session as the House and Senate bitterly disagreed, was voted down 72-41 Friday after a rousing, nearly seven-hour debate during which nearly 60 lawmakers spoke.

It was an attempt by the Senate to draw down $18 billion federal dollars and give it to hundreds of thousands of Floridians to purchase private health insurance instead of putting them in the regular Medicaid program.

But Republicans insisted it would still expand President Barack Obama's health care overhaul and increase the federal deficit. Even supporters acknowledged the bill would cover far fewer people than the 800,000 who are eligible. Gov. Rick Scott was also strongly opposed.

"I know an entitlement when I see one. (The Senate bill) is simply Obamacare Medicaid expansion with a clever name," said Rep. John Wood, R-Winter Haven.

The vote came on the fifth day of a special session that was required after the House and Senate failed to pass a budget during their regular 60-day session. The two chambers were divided over health care, including whether to expand health care coverage.

During the regular session, the House never voted on the Senate proposal. That changed after an emotionally charged debate that fell along party lines as legislators either called it disastrous or life-saving. The final vote was divided, although four Republicans voted with the Democrats.

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Florida Medicaid expansion passes Senate, faces dead end in House posted on 6/4/15

by john kennedy | Palm Beach Post

FL Senate ChamberTALLAHASSEE — Despite facing a political brick wall in the state House, the Senate approved its privatized form of Medicaid expansion Wednesday, arguing that health coverage for uninsured Floridians is vital both to hospital financing and the state’s economy.

But short of reaching what several senators termed a “grand bargain,” the House today is poised to kill the Florida Health Insurance Exchange, which House Speaker Steve Crisafulli and Gov. Rick Scott condemn as an “expansion of Obamacare.”

The Senate approved the measure on an overwhelming vote of 33-3, but Senate President Andy Gardiner said that after today’s expected formal rejection by House members, lawmakers are ready to pivot quickly toward crafting a budget for the year beginning July 1. Work on crafting the new spending plan is expected to begin this weekend.

“At the end of the day, we have to do a budget,” said Gardiner, R-Orlando. “It’s not about personalities, it’s not about lawsuits, it’s not about threats. It’s not even our money, it’s taxpayers’ money. We’ll get our job done.”

The Senate vote came on the third day of a scheduled three-week special session. Daily costs to taxpayers will likely range between almost $24,000 to $87,000, according to historical data.

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