The House finally unveiled its alternative to Medicaid expansion this week, which would create the Florida Health Choices Plus program to offer health accounts to qualifying individuals who fall below 100 percent of the federal poverty level.  The proposal is similar to that released by Sen. Bean’s Health Policy Committee in that it does not use any federal Affordable Care Act funds, and requires the state and program enrollees to jointly fund the accounts; however, it would require the state to provide $2000 per enrollee account (subject to annual appropriations), which is far more than the state’s cost responsibility under Sen. Bean’s plan and thus significantly increases the estimated fiscal impact.  Sen. Negron’s proposal, SB 1816, differs significantly from the other two proposals, but appears to have support from the Governor.   As the two chambers remain deeply divided on this issue, FAC anticipates much debate over the competing proposals in the coming weeks.

Read more on Health and Human Services related bills…

Disposition of Human Remains
HB 171 (R. Rooney)/SB 370 (S. Sachs)

  • Summary:
  • Clarifies and updates the statutes relating to unclaimed and indigent burials
  • Provides that counties may adopt policies and procedures for the final disposition of unclaimed human remains
  • Authorizes counties to make final disposition of unclaimed human remains under certain circumstances
  • New language (from last year): allows certain veterans organizations to assist with recovery and interment of unclaimed cremated remains of veterans
    • Status: HB 171 passed the full House unanimously and is now in Senate messages.  SB 370 passed its third committee, Senate Judiciary, unanimously, and has only one remaining committee stop before moving to the Senate floor. 

Smoking Preemption/Clean Indoor Air Act
HB 439 (R. Hagar)/SB 258 (S. Bradley)

  • Summary:
  • Currently, sec. 386.209, F.S. preempts the regulation of smoking to the state, except that school districts can further restrict smoking on school district property.
  • Bills would remove counties and cities from the preemption, allowing them to further restrict smoking on certain county or municipal outdoor property if they choose do to so by local ordinance. 
    • Status:
    • SB 258 passed unanimously in Senate Regulated Industries, amended to specify the locations where local governments can restrict smoking as well as the processes for enforcing local smoking ordinances. Additionally, non-smoking areas would have to be clearly defined, and designated smoking areas would be required.
    • SB 258 passed 6-3 in Senate Health Policy.  The bill allows a city or county to require, as a condition for a lease on property that it owns or controls, that smoking be prohibited on the property; however, it was amended in Senate Health Policy to provide that such a restriction may not apply to a pre-existing lease, including a lease renewal, without the lessee’s consent.
    • HB 439 will not be heard in the House this Session.
    • The bill is dead this year; however, FAC is already working with the various stakeholders in preparation for next Session, as this issue will return.  

County Contributions to Medicaid Program
SB 1244 (S. Soto)/HB 1117 (R. Wood)

  • Summary: Creates study group to evaluate percentage of funds that counties are required to contribute to Medicaid program & provide recommendations to Governor/Legislature.
  • Status: 4 committee referrals in Senate; 3 in House; currently in Health & Human Services Appropriations.

SB 1816 – Relating to Health Care (Appropriations)

  • Summary: Creates “Healthy Florida” within the Florida Healthy Kids Corporation, to provide individuals who fall below 138% of the federal poverty level with access to subsidized private health insurance. 
    • The plan is an alternative to Medicaid expansion pursuant to the Affordable Care Act (ACA), but relies on the same federal dollars for funding.  Federal approval would be required in order for the state to gain access to these funds.
    • Enrollees would be offered choices of plans, which would be required to cover certain services and provide health savings accounts. Enrollees would have to meet certain cost-sharing requirements based on their income, which could be as low as $3 or $4 co-pays.
    • Plans would be required to meet an 85 percent medical loss ratio.
  • Status: SPB 7038 was introduced as a committee bill, SB 1816, and referred to the Health and Human Services Appropriations and full Appropriations committees. 

SB 1844 – Relating to Health Choice Plus Program (Health Policy)

  • Summary: Creates the Health Choice Plus (HCP) program to offer a health benefits program for uninsured persons ages 19 to 64 who fall below 100 percent of the federal poverty level but are not otherwise eligible for Medicaid.  The program would be managed and administered by the existing Florida Health Choices Corporation.
    • Health benefits accounts provided to enrollees would be jointly funded by the recipients and the state (subject to annual appropriations) and would not rely on the federal funds made available to Florida under the ACA.
    • Funds deposited into health benefits accounts could be used by the account holder to offset health care costs or purchase health care services from the marketplace.
    • The bill has an estimated fiscal impact of $15,275,000 for SFY 2013-14.
  • Status: SPB 7144 was filed as SB 1844 and referred to two committees.   

PCB-SPPACA3 – Relating to Health Care Coverage

  • Summary: Creates the Florida Health Choices Plus Program within the Florida Health Choices Program, to assist certain uninsured persons between ages 19 to 64 who fall below 100 percent of the federal poverty level but are not otherwise eligible for Medicaid,  The program would be managed and administered by the existing Florida Health Choices Corporation.
    • Similar to SB 7144 (by Sen. Bean/Health Policy Committee), the accounts provided under the plan would be jointly funded by the state and enrollees, and would not rely on the federal funds made available to Florida under the Affordable Care Act.
    • The program would provide CARE accounts (contribution amount for responsible expenditures) to enrollees.  Each enrollee would receive $2000 in his or her CARE account, subject to annual appropriation, to purchase health coverage products and services available in the marketplace.  To maintain eligibility, enrollees would be required to contribute $25 per month into their individual CARE accounts. 
    • The plan would have a fiscal impact of $11.9M in FY 2014, although the plan would not be launched until late in the fiscal year (April 2014).  The fiscal impact is estimated to be $120M in FY 2015, rising to $266M in FY 2023. 
  • Status: PCB-SPPACA3 was filed on April 11, and will be discussed by the House Select Committee on Patient Protection and Affordable Care Act on April 15.  The proposal, which is the House’s version of a Florida-specific, Medicaid-expansion alternative, is similar in many ways to Sen. Bean’s plan.  In response to the House plan being unveiled, Governor Scott released a statement expressing his continued support for a proposal that utilizes the federal ACA funds available to Florida.