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House Backs Changes For State Workers, Hospitals

Jun 12, 2015
Originally published on June 12, 2015 2:20 pm

Pitching more competition and choices in the health-care system, the House on Friday passed six bills that include proposals to revamp health coverage for state employees and eliminate key regulations in the hospital industry.

But as lawmakers head into the final week of a special legislative session, it remains unclear whether the Senate will pass any of the bills. Senate President Andy Gardiner, R-Orlando, remained non-committal Friday, though he suggested the House's proposed changes to employee health insurance likely will not pass.

"I haven't really looked at it," Gardiner said. "I think it probably, of all those, that's, just from a timing standpoint, the one that may have a little bit more of a challenge."

The employee-insurance bill (HB 21A), sponsored by House Health & Human Services Chairman Jason Brodeur, R-Sanford, drew heavy debate before passing in a 71-28 vote along party lines. The bill, in part, would ultimately lead to employees in 2018 choosing among insurance plans with four different benefit levels and would offer incentives for employees shifting away from the richest plans.

Democrats warned that the bill could water down benefits for state employees and that lawmakers should not consider the changes during a special session called to pass a budget for the upcoming fiscal year.

"This bill is definitely not going to balance our budget,'' Rep. Irv Slosberg, D-Boca Raton, said.

But Rep. Travis Cummings, R-Orange Park, said lawmakers have considered the changes since at least 2012. Republican lawmakers also said the plan would not reduce benefits for state workers and that it would give employees more choices in their health coverage.

"This is all about empowering patients to make choices," Rep. Gayle Harrell, R-Stuart, said.

Another heavily debated bill (HB 31A), also sponsored by Brodeur, would eliminate what is known as the "certificate of need" regulatory process for hospitals. That process, which has long been controversial, regulates such issues as the construction and replacement of hospitals.

House Health Innovation Chairman Ken Roberson, R-Punta Gorda, said certificates of need were originally designed to help hold down health-care costs, at least in part because it is expensive to build and equip hospitals. But Roberson said the process has not lowered costs. Supporters also say eliminating certificates of need would increase competition in the hospital industry.

"It's just unnecessary regulation,'' Brodeur said before House members voted 72-28 along party lines to approve the bill.

But Democrats raised a number of objections, including arguments that adding more hospitals would exacerbate shortages of physicians and nurses. Also, House Minority Leader Mark Pafford, D-West Palm Beach, said new hospitals would have an incentive to admit more patients, which could increase costs.

Health-care issues have dominated the special legislative session, which started June 1 and could last through June 20. House Republican leaders flatly rejected a Senate plan to use federal Medicaid money to expand health coverage and offered bills that took a far-different approach to overhauling the health system.

The other bills approved Friday included a measure (HB 23A) that 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.

Also, the bills included a proposal (HB 27A) that would allow advanced-registered nurse practitioners and physician assistants to prescribe controlled substances; a proposal (HB 25A) that would make clear what are known as "direct primary care" agreements between patients and doctors are not regulated as insurance; and a proposal (HB 29A) that would require hospitals to notify physicians at least 120 days before closing obstetrical departments.

At least some of the bills are expected to go before the Senate Health Policy Committee on Tuesday. Gardiner said Friday he would look to committee Chairman Aaron Bean, R-Fernandina Beach, and committee members on the issues.