I knew we’d have a fight on our hands to defend the progress made by the Obama administration in reforming our health care system. I wake up every day recognizing that millions of my fellow Floridians could lose coverage and access if the current Administration’s efforts to undermine the health care law are successful.
I admit there are problems with the Affordable Care Act (ACA). But we can’t afford to start over, as some are suggesting with their health care proposals. Why would people support that and lose the health care they enjoy?
With the passage of the ACA, millions of Americans could obtain coverage they never had before: 91 percent of Americans have insurance for the first time in American history. As President of the Pinellas County Young Democrats, I’ve seen the importance of young people staying on their parents’ insurance until age twenty-six, and the impact of the new protections for people with pre-existing conditions. We need to build on the advances we’ve made so far on health coverage that more than 180 million Americans rely on.
Congress should be focusing on common-sense policies to cover the remaining 9 percent of Americans still worried about what will happen if they or their family member gets sick or goes to the hospital — not upending our health care system through sweeping, unrealistic and unattainable legislation.
With the 2018 elections approaching, we must support candidates who prioritize pragmatic, patient-centered health care policies. We need leadership in Washington willing to work hard to preserve the current health coverage that millions enjoy and fix what isn’t working to make health care accessible for all Americans.
Johnny Boykins is president of the Pinellas County Young Democrats.
As an educator who has taught in both district-run and charter public schools, I am astounded when I read articles or hear claims from school board members around the state charter schools take away funding from the local public-school system.
That is not the case.
Charter schools provide options for families who can’t afford to live in communities with A-rated neighborhood schools. Every student deserves the same opportunity to be educated, and charters just open another door for them to receive what they rightfully deserve.
These parents should not be shamed for their choices.
What’s more, my own experience in Hillsborough County shows charter schools are partners in our local public-school system.
I have lived in the Riverview area for five years and I have seen tremendous growth in the area. With many homes being built, new families with children have moved to this part of the county. Now nearby schools, especially high-performing ones, have become overcrowded. Charter schools like BridgePrep Academy, where I teach kindergarten, help relieve the strain on the school district.
Our school helps students reach the same standards as other public schools, and offers an environment where instruction is more individualized and tailored to each student’s needs.
I can personally attest, as both a teacher and a parent. I have experienced hardship securing a quality education for my own children. When I relocated to Hillsborough County from Miami-Dade in 2012, I was faced with minimal educational choices. My children were zoned to a school that had received consecutive D’s. For me, it was not a suitable option.
As a single mother, homeschooling was not an option, either. I had heard many negative stories about charter schools. But I was blessed with the opportunity to send my children to Winthrop Charter. It was a great fit for my kids, and one of the best decisions I have made.
Fast-forward a few years later, they now attend the school where I teach. I have watched their love for learning flourish. They are in an environment where they are more comfortable expressing themselves, while also being challenged academically.
Thousands of families all over this state are in similar positions. We do not all have the opportunity to buy our way into high-class neighborhoods with high-performing neighborhood schools. But we still believe our children deserve a high-class education. Many people see the brand-new charter schools opening and assume we labor in luxury. But charter schools actually operate at a disadvantage.
Many district-run public schools have been in operation for years and have accrued many curricular essentials over time. We are not allotted the same essential resources. Nor are funds readily available to purchase them.
It is a fact that charter schools have historically received less funding per student than district schools. Although recent legislation has helped make funding more equal, charter schools like my current school still must hold fundraisers to provide vital student services like developmental reading assessment kits, accommodation testing materials and math manipulatives.
While the Hillsborough County school district has one of Florida’s most responsive charter school support teams, we still do not receive the same support from the central office as our counterparts in the district.
I have educated young minds for 12 years. Most of my career has been in district-run schools: Six years in Miami-Dade County and two years with the Hillsborough County district before I began teaching in charters, first with Charter Schools USA and now BridgePrep.
Every year, my goal has been to give my students the best I can to prepare them for their future. I believe that is what every educator wants for their students. We are all in this together. We all want our students of varying needs and abilities to receive necessary support services. We all rely on support and appreciation from parents, the community, administrators and our professional counterparts. We all desire salaries that allow us to support our families and still allow us to make purchases to benefit our classroom. We all desire to feel safe at our school sites. Why is there disagreement when we all want the same things?
I believe district and charter school educators should join forces to raise a stronger voice for quality public education. The students we all educate will become our doctors, lawyers and entrepreneurs.
We educate the world. Let’s work together to change it.
Marsha Edwards is an educator who lives in the Tampa Bay-area.
It’s good when a Florida business can partner with a huge corporation on a project that will revive a struggling community. So, it’s particularly distressing when the corporation acts like a bully, pushing aside the interests of its smaller partner — and the entire community — so it can grab a bigger profit for itself.
Unfortunately, that’s what’s happening right now in the small Central Florida town of Fort Meade, which has been struggling to recover from the closure of phosphate mines that once drove the economy of Polk County. The decision by Duke Energy to abandon its partner, U.S. EcoGen, could cost the local community hundreds of jobs and millions of dollars.
As a director of the Florida Alliance for Consumers and Taxpayers (FACT), an organization that weighs in on consumer issues, and a longtime advocate for local communities, I have seen far too many instances where big corporations run over those who place their trust in them. In this case, Duke Energy’s cash grab has caught the attention of some important state legislators.
A little background: Duke Energy partnered with U.S. EcoGen in 2011 to build a $400 million plant to produce biomass renewable energy, which would provide Duke with enough electricity to power approximately 10,000 homes. Relying on this agreement, U.S. EcoGen has already spent more than $40 million developing the project and bought more than 1,300 acres in Polk County for the new facility. The project was delayed by everything from the discovery of gopher tortoises to the new federal tax reform law — things beyond the control of the smaller company. U.S. EcoGen asked Duke Energy for a one-year extension, meaning it would start delivering power in 2020, but the mega-corporation said no.
This refusal is both baffling and harmful to consumers, since the state Public Service Commission has said the project would save ratepayers almost $60 million. Baffling, that is, unless you consider that it looks like Duke Energy has taken an interest in operating its own renewable energy business. In a PSC document from last year, Duke Energy asked permission to enter the renewable energy field, which would make it a direct competitor with U.S. EcoGen — not a partner. Unless, of course, it found a way to stop U.S. EcoGen’s plant from ever opening.
Unsurprisingly, the project has wide support from the local community who sees this as a unique opportunity to diversify their economic future. Additionally, State Sen. Aaron Bean and Rep. Jay Trumbull, who chair legislative panels that oversee energy and utilities’ issues, have written letters encouraging Duke Energy to move forward with this project. They cite the financial implications for the community, the potential loss of hundreds of high-paying jobs, and the impact on consumers.
Duke Energy has a real chance to do something good for its ratepayers, good for this community, and good for the public. It’s not too late for the corporation to change its mind, so for the sake of this community and Florida, let’s hope that Duke does the right thing.
John Thomas is a director with the Florida Alliance for Consumers and Taxpayers. He has decades of experience working with local governments and elected officials.
A relatively new trend is emerging to get these prized electors to the polls — vote pledging — and it is finally warranting closer scrutiny. No doubt, this strategy will be put to the test by field campaigns in both the 2018 midterms and beyond.
First, some background; in the political ecosystem, the “youth vote” is a somewhat new concept.
Driven in large part by the military draft, which conscripted men between the ages of 18 and 21, the push to lower the voting age moved quickly.
In March 1971, the U.S. Senate voted 94—0 in favor of proposing a Constitutional amendment, guaranteeing the minimum voting age could not be higher than 18. Thirteen days later, the House of Representatives voted 401—19 in favor of the proposed amendment.
On July 1, 1971, the 26th Amendment was ratified, giving those 18 years of age and older the right to vote.
Nevertheless, in 1972, only 51 percent of 18 to 24-year-olds made their way to the ballot box, compared to 70 percent of those ages 25 years and older.
Forty-four years later, the participation rates of the younger demographic are no better, lagging behind those 25 years of age and older, with 50 percent participation as compared to 65 percent.
We can point to many reasons for the participation gap between older and younger voters, including lack of geographic stability, logistics of when and where to vote (usually a deterrent to newly registered voters), education and income.
Some evidence suggests allowing young citizens to register to vote before they are eligible, may increase voter turnout from this cohort. It has long been argued, with plenty of evidence to support, a fully operational field and grassroots campaign can play a critical factor in mobilizing specific voting blocks in successful campaigns.
Slowly, after some experimentation, a few field campaigns have realized the key to votes at the ballot box was securing a commitment from the voter and then following up to get them to stick to their pledge.
This approach likely overshadowed — yielding more significant results — the more traditional multiple door/phone outreach which was common until the 2004 cycle.
Modern and advanced field campaigns continue to test the effectiveness of collecting pledges and issuing reminders in person and across social media platforms.
Highly technical and sophisticated campaigns — which are adequately funded and have the workforce to do so — will ask voters to fill out pledge cards and personally return those cards ahead of Election Day.
This “get out the vote” (GOTV) tactic can be used to attract voters of all ages.
Few field campaigns indeed focus on mobilizing young voters because they believe there is a low return on investment (votes). However, “vote pledges” may be the tactic field campaigns can use to increase turnout in the under-24 voting bloc.
Vote pledging is a simple approach based on the premise that if a voter makes an “in-person commitment” to specific future behavior, they are more likely to follow through than a voter who was not asked explicitly to commit and sign a card.
An in-person commitment can be at the door or possibly over the phone.
This campaign tactic bridges cognitive psychology, which focuses on mental processes especially concerning the internal events occurring between sensory stimulation, open expression of behavior and comparative behaviorism.
Simply put, it suggests commitments to perform a specific action can significantly increase the likelihood of such action.
The mechanism of soliciting (and then enforcing) promises may be the most powerful tool in a field campaign’s psychological arsenal. While vote pledging is a relatively straightforward mobilization tactic, it invokes basic psychological processes above and beyond the traditional demographic parameters in models of voter turnout, such as education, race and age.
Theories of commitment, cognitive dissonance and self-perception imply pledging to vote may engage a whole host of behavioral mechanisms — and can be used to explain how an individual’s own actions can be used to persuade future performance.
While it appears simplistic, this theory has rarely beentested by researchers in the political arena. A randomized controlled experiment was conducted during the 2016 Pennsylvania primary election and the 2016 Colorado general election.
Experiments revealed individuals who pledged to vote were more likely to turn out than those contacted using standard campaign materials, such as mailers and an election’s general information guides.
Further, pledging to vote significantly increased turnout among individuals who had never previously cast a ballot, thus having a particularly significant effect for bringing new voters into the electorate in large numbers, rather than just ensuring turnout among regular voters.
Overall, pledging to vote increased voter turnout by 3.7 points among all subjects and 5.6 points for people who had never voted before.
Showing a commitment behind “pledge to vote” increases the participation in elections, and could have real implications for increasing youth turnout.
These findings lend support for theories of commitment and have practical consequences for field campaign mobilization efforts with the goal of expanding the electorate.
It’s also a smart tactic we may see more of from campaigns in the 2018 cycle.
Successful field campaigns must evolve to include a compressive approach, which includes eliciting a pledge (or commitment) to vote coupled with a follow up to reinforce this pledge — all while staying within budget.
Kevin Sweeny is Operations Director for the Florida Justice Association.
In the aftermath of the horrific mass shooting at their school, the students of Marjory Stoneman Douglas High School have shown remarkable character and courage. Their resilience and capability to advocate for themselves, their fallen classmates and their peers across Florida, and throughout the country, in the midst of this trauma shows mettle rarely found in public life.
While these students continue to march forward and hold elected leaders accountable, it is worth pausing to note that their advocacy compelled Florida’s state government to pass gun safety reforms for the first time in nearly 20 years.
As is often the case in Florida though, Republican leadership rolled common-sense reforms like raising the age to purchase a rifle to 21, banning bump stocks, and more money for school safety, into a bill that would also arm our teachers.
Unfortunately, the tragic reality is it took three of the most horrific mass shootings ever, all occurring in our state in the past two years, and the fierce advocacy and leadership of our state’s children to force a real conversation about gun violence among our elected leaders.
As Attorney General, I will use the independence of the office to hold state government accountable, fully investigate these horrific shootings and other acts of violence, prosecute those breaking the laws we already have in place, and challenge unjust federal laws that provide near-total immunity for gun manufacturers who should be held accountable for their role in gun violence.
Stopping gun violence requires our next Attorney General to embrace the independence of the office fully. Florida’s Attorney General is not appointed by the Governor but elected by the people.
However, over the last 20 years, Florida’s Republican Attorneys General have done little to address gun violence proactively and have acted more like the personal attorneys of the Governor and Republican leadership in the Legislature.
The resulting deference has resulted in our state’s top legal officer fighting for partisan gains and justifying the National Rifle Association’s agenda rather than standing for the safety of the people of Florida.
The most egregious example of this deference to the legislature and Governor’s partisan agenda is the pre-emption of local rules by the state Legislature, even going so far as to make it a crime for local officials to pass gun safety reforms in their communities.
There are tremendous differences between the cities and counties in Florida. Solutions that make sense in Escambia County could be harmful or unhelpful to the residents of Hillsborough County.
Unfortunately, this is the current system levied upon us by the last 20 years of Florida leaders.
Several mayors, city councils, and local municipalities are in the process of preparing to challenge this pre-emption statute. Additionally, several candidates for Governor have stated they will challenge this law if elected.
As Attorney General, I know my top priority is protecting Florida families and keeping the people of Florida safe. I will not waste the state’s resources or taxpayer dollars defending arbitrary and thoughtless policies that prevent local solutions.
I will not defend the state’s current pre-emption policy on gun laws.
The status quo in Tallahassee has based gun laws entirely upon the directives of lobbyists for the Gun Lobby and completely disregards any real concern for public safety or home rule. The truth is we can respect the Second Amendment while passing common-sense gun safety legislation and respecting local control.
Empowering local governments can help reduce gun violence, but it is just one of the steps that must be taken.
As Attorney General, I will fully utilize the office of the Statewide Prosecutor to investigate gun violence across jurisdictions.
These extraordinary powers to investigate and prosecute organized crime, violence, and drug trafficking have been underutilized and mismanaged over the past 20 years. Three horrific mass shootings in less than two years and an epidemic of gun violence where a child is shot every 17 hours in our state demands an investigation to fully understand how violent criminals are gaining access to guns, bullets and other weapons.
We must understand the common threads that allowed the shootings at Pulse, the Ft. Lauderdale airport, and Marjory Stoneman Douglas High School to occur.
Moreover, we must go beyond legal prosecutions to proactively recommend precise legislation to ban assault weapons and make it more difficult to access illegal handguns.
By better understanding the common threads between these shootings, we can better prevent future attacks.
The recommendations of the Statewide Prosecutor and local prosecutors who have been proactively fighting back against this tide of violence can be paired with common sense legislation including banning individuals on the terrorist watch list from obtaining a gun, making it harder for convicted domestic abusers to purchase a gun, and requiring schools to have and practice active shooter protection plans.
One of the most effective tactics available to an Attorney General is participating in joint litigation with other Attorneys General or individuals to support cases defending the interests of the people of Florida.
For all the lives lost, families destroyed, and psychological torment caused by gun violence, the one group who has never been held accountable is gun manufacturers. This is because gun manufacturers are the only industry in the United States that have near total immunity or a nearly complete shield from being held accountable for the products they produce through the federal Protection of Lawful Commerce in Arms Act, or PLCAA.
I believe this law is unconstitutional, and as Attorney General, I will actively seek out opportunities to challenge the PLCAA either alone or with other states, in order to get this question in front of the Supreme Court of the United States.
As Florida’s chief law enforcement officer and top lawyer, I believe no one industry should be provided near total immunity from being held accountable. On a constitutional basis, I see the federal passage of the PLCAA as a tremendous overreach of Congress.
I support the Second Amendment and believe the Constitution of the United States protects the rights of individuals to have a gun. As someone who grew up in North Florida, I understand the importance hunting plays as a cultural bonding agent for many Floridians.
However, gun violence is an epidemic in Florida.
Our next Attorney General must take these steps and other actions to not only honor the memory of those who were lost at the Pulse Nightclub massacre, the Ft. Lauderdale Airport shooting, Marjory Stoneman Douglas High School, and those killed in acts of gun violence every day in Florida, but to also keep our families safe.
Sean Shaw is currently a member of the Florida House of Representatives for District 61 and the Democratic candidate for Attorney General.
As the nationwide opioid epidemic continues to destroy families, communities and lives across the country, Congress is currently considering dozens of bills to address this public health crisis. Their action is critical, and time is of the essence.
As Congress deliberates legislation to combat the opioid epidemic, expanding access to naloxone through co-prescription should be a top priority. The Surgeon General has emphasized the importance of naloxone co-prescriptions for certain patients at an increased risk for opioid misuse, including certain Medicare and Medicaid patients. The Center for Disease Control (CDC) has also come to the same conclusion.
Opioids are incredibly unpredictable, and even when taking medication as prescribed, patients can still accidentally overdose. That’s where naloxone comes in.
Opioid addiction and misuse do not discriminate based on age, gender or skin color. We are all at risk. As the president and CEO of the Florida State Hispanic Chamber of Commerce, I am especially concerned about the impact on our Hispanic community.
Older Americans are at risk, too. A recent Washington Post article discusses the opioid crisis’ impact on the elderly, and states: “One in three older Americans with Medicare drug coverage are prescribed opioid painkillers.” Here in Florida, that statistic is especially concerning, because we have such a high population of seniors.
It is extremely important to arm at-risk patients with the potentially life-saving tool they need to avoid fatal overdoses. The federal government must follow their own advice and help increase access to naloxone.
Despite its potentially life-saving ability, naloxone is still not readily available to all CDC-recommended patients. One main reason is cost, which is why federal funding is so important. And, co-prescriptions are cost-effective, and can actually save the government more money in the long run. A National Institute of Health (NIH) study found patients receiving naloxone co-prescriptions had 63 percent fewer emergency room visits in one year compared to patients without a co-prescription. Considering Medicaid and Medicare pay for more than 50 percent and 68 percent of opioid-related emergency room visits, this policy change is also a fiscal win.
Encouraging co-prescription for Medicare and Medicaid patients and those at-risk individuals identified by the Surgeon General is a powerful first step toward reversing accidental opioid overdoses.
It is up to us to urge lawmakers, such as Florida Reps. Gus Bilirakis and Kathy Castor, to mandate co-prescription in future legislation.
Our priority should be to preserve life at any cost.
Julio Fuentes is the president and CEO of the Florida State Hispanic Chamber of Commerce.
Hurricane season charged into Florida Friday with one storm already on the books. Subtropical Storm Alberto dampened many Memorial Day festivities but serves as a good reminder that Floridians must be prepared for storms and the damage they may cause.
Protecting against storms doesn’t end with stocking up on supplies and shoring up property. It also means being on the alert for insurance abuse and scams, and not becoming a victim.
Hurricanes and significant weather events create opportunities for unscrupulous contractors and their attorneys to take advantage of Assignment of Benefits, or AOB, when dealing with insurance claims. By pressuring consumers into signing an AOB, they take control of an insurance policy, paving the way to inflate the cost or scope of repairs, then file lawsuits against insurance companies that deny the claim. Consumers pay the price in the form of higher insurance rates.
We saw this last year during Hurricane Irma and, unfortunately, we’re likely to see it again this year, unless Florida’s Legislature does something to stop AOB abuse. Consumers who sustain damage during a storm should call their insurer or their agent first before signing an AOB.
The Consumer Protection Coalition, which is led by the Florida Chamber of Commerce, has been working since 2016 to change AOB laws to curb the abuse. Proposed bills would allow consumers to rescind an AOB without penalties or fines and require contractors to submit written cost estimates for work, among other common-sense provisions.
For the past two years, the legislation has been approved by the Florida House but has died in the Senate, despite growing evidence of the problem and testimonials from victims of AOB abuse. AOB abuse has grown from being nearly nonexistent 15 years ago into a statewide problem that’s threatening the dream of homeownership for many Floridians and the accessibility of affordable insurance.
While it’s unfortunate that Florida must endure another hurricane season without AOB reform, we are hopeful lawmakers and incoming Senate and House leaders will see the harmful impact AOB abuse is having on hardworking Florida families and pass meaningful legislation in 2019.
The early arrival of Florida’s first storm, coupled with forecasters’ predictions of an active hurricane season, should be warnings for all Floridians to protect themselves against AOB abuse.
Mark Wilson is president and chief executive officer of the Florida Chamber of Commerce.
Thanks to legislative action, Floridians will vote this fall on a constitutional amendment subjecting any increase in fees or taxes — whether state or local — to a 2/3 supermajority vote by the requisite legislative body. Florida is already one of 17 states imposing at least some sort of supermajority requirement on tax increases.
But currently, such a limitation (a three-fifths supermajority) only applies to increases in the corporate income tax rate above 5 percent.
This bold decision would further cement the state’s position as an economic powerhouse. Let’s explore the rationale for such taxpayer protection.
Supermajority requirements counteract the propensity of some legislators to levy higher taxes on a minority of residents under the auspices of providing more services to others. Unfortunately, those dollars forcibly contributed to the state are no longer available for investment in the economy. Politicians may escape widespread criticism for the tax increase — and may actually receive acclaim for the perceived boost in services.
However, economic opportunities are diminished by soaking up available capital for investment and by disincentivizing additional output by those taxed.
Over the long term, data show low-tax states enjoy more rapid economic growth and even greater growth in tax revenue than their high-state counterparts. A supermajority requirement for tax hikes keeps the inclination to raise taxes for political gain in check.
Unfortunately, tax increases often prove far easier to implement than meaningful tax cuts because of a divide and conquer political approach. Sometimes a narrow slice of the populace that will disproportionately benefit from increased spending will place outsized pressure on politicians in support of tax increases.
This especially occurs when the tax increase will only impact a relatively limited number of taxpayers or if a broad-based tax increase is hidden or fairly negligible on any one entity. Regardless of the political dynamics, economic growth overall is negatively impacted. Compounded over time, a series of such tax increases severely constricts opportunities.
A supermajority requirement prevents this tendency of tax hikes to gradually ratchet up.
Temporary shifts in political winds often threaten to erase the hard-fought gains of past reforms. This is particularly important for entrepreneurs and companies. Investors seek to risk their capital only on ventures with an expected rate of return exceeding a certain required risk-adjusted level. After all, not all ventures will prove successful.
As such, the higher the tax rate, the lower expected after-tax return for all projects.
Some ventures with a previously acceptable risk-adjusted expected rate of return will no longer qualify as an acceptable investment given a higher tax rate. Fewer acceptable investment options results in fewer employment opportunities for residents statewide. A supermajority requirement for tax hikes provides job creators greater peace of mind to make these desirable long-term investments by safeguarding pro-growth reforms and enhancing expectations that a state’s business climate will be stable.
Of course, some argue that supermajority requirements kneecap a state from making needed investments in the future. This ignores the fact that even in the absence of a tax rate increase, long-term, real (inflation-adjusted) per capita revenue growth occurs with only temporary, modest interruptions.
This occurs thanks to an economy in the United States which grows nearly each and every year in economic output per capita. Innovation combined with ever-expanding capital deployment ensures this growth.
It’s the reason the standard of living — measured by such things as house size, vehicles per family, food consumed, and appliances — continues to increase for all economic classes. Even a stable tax rate yields more revenue adjusted for inflation with such growth.
Others complain that a supermajority requirement can hamper needs, such as teacher salaries, during times of economic crises as revenue plummets. But if states handle times of surplus correctly, a rainy-day fund can provide temporary needed funds to close a budget gap.
Remember, during economic expansion, real per capita revenue increases even with a stable tax rate. Some of this excess revenue should be diverted into savings in order to supplement spending during times of economic crises.
At any rate, a supermajority of legislators may still enact a tax increase if the circumstances are dire enough.
A supermajority requirement spared Californians from tax increases even more draconian than those recently approved by a far-left legislature. In Colorado, other restrictions on legislative tax increases have helped maintain property taxes at only a fraction of those imposed in states such as New Jersey.
More than a dozen other states, red and blue alike, continue to maintain these requirements. Such safeguards wisely protect taxpayers from future politicians overly zealous to extract more from their wallets.
Joel Griffith is director of the Center for State Fiscal Reform at the American Legislative Exchange Council. Jonathan Williams is chief economist at the American Legislative Exchange Council.
Recently the Florida Association of Health Plans, Inc. (FAHP) joined with consumer advocates to eliminate the practice of balance billing — which far too often overwhelmed Florida families with surprise medical bills above their insurance coverage after they or a loved one were in a catastrophic accident. Thanks to the Florida Legislature’s recognition that this practice was financially ruinous and overly burdensome on Florida families, a law was passed in 2016 that effectively eliminated balance billing for most medical bills.
Ambulance transportation, however, was not included in the balance billing prohibition because of claims from ambulance companies, as well as government-run ambulance departments, that they need to bill patients in excess of what insurance covers in order to fund expensive emergency-response services on a 24-hour basis. The ambulance companies or government-run ambulance departments also claim the full cost of an ambulance trip doesn’t amount to a level that would financially devastate families. While this may be arguable with ground ambulance services, considering the average trip is billed at $1,000-$2,000, air ambulance trips are clearly billing patients at levels that are unaffordable to even the most affluent patients. For example, recently the 11th Circuit Court of Appeals ruled that a family, whose child was killed in a car accident, must pay a balance bill of more than $17,000 to an air ambulance company – after the family’s insurer reimbursed the company, Air Methods Corp., almost $16,000 for the trip to the hospital.
The reason? The court ruled the amount the insurer paid is pre-empted by the federal Airline Deregulation Act and the patient is liable for whatever amount of money the air ambulance decides to bill the patient for the service above what the insurer paid.
The underlying issue is air ambulance companies are using a federal act designed for commercial airlines as a cover to bill patients whatever amount they see fit. Air ambulance companies don’t just set a price based on actual cost and a profit for a one-time air ambulance trip to a hospital as you would expect; but, instead, they are able to base their pricing on the cost to have emergency transportation available 24-hours-a-day, rather than the actual cost incurred by the patient. Considering the patient is not in a position to ask what the charge will be before being transported, the size of the bill may be based on whether the air ambulance has a large volume of trips or whether the air ambulance company has a small volume of trips resulting in enormous bills to the few patients.
You may ask why this type of pricing occurs, and the answer is with no market forces to encourage efficiencies, there are no incentives for air ambulance companies to look at minimizing costs needed to operate 24-hour air ambulance services. FAHP thinks it is time to challenge the pricing models air ambulances currently use; otherwise, air ambulances will not attempt to find ways to lower costs, because the patient is on the hook for whatever amount is billed. Without a market force pushing back on unreasonable prices, air ambulance companies will continue to send enormous bills in excess of the cost of the actual transportation, and Florida families will continue to suffer under the weight of air ambulance bills.
While, Florida’s health plans, with the assistance of Representative MaryLynn Magar (chair of the Florida House Health Innovation Subcommittee), have participated in roundtable discussions with air ambulance companies, aimed at coming to pricing agreements that would limit or eliminate this balance-billing practice, these discussions to date haven’t led to lower charges to patients in Florida by air ambulances.
If air ambulance companies are not willing to come to the table to stymie the burden of air ambulance transportation fees on Florida families and, instead, continue to run to court and hide behind a federal act designed for commercial airlines, FAHP urges the Florida Legislature to look again at ways to disallow air ambulances from balance billing that are not pre-empted or prohibited by the Airline Deregulation Act.
It is our sincere belief that no family should have to face astronomic medical bills following a catastrophic or life-altering accident, and FAHP is committed to championing the end of the practice of balance billing once and for all.
Audrey Brown is president and CEO of the Florida Association of Health Plans, Inc.
Florida nursing care centers and their residents have seen more than their share of hurricane seasons, but few have carried the wallop we all experienced last year.
The destructive season was highlighted by Hurricane Irma, a Category 4 storm that raced up the spine of our state, causing widespread devastation and resulting in the tragic loss of life at a South Florida nursing home. That center wasn’t part of Florida Health Care Association (FHCA), but the more than 550 nursing centers we do represent all shared in the sadness for the families and the black cloud it left hanging over our profession.
Many Floridians are unaware of the countless acts of heroism by caregivers and the hundreds of successful evacuations and shelterings in place our members conducted during Irma.
With the 2018 hurricane season almost upon us, it’s important to recognize the work they have continued in the months that followed to ensure the safety of the frail residents entrusted to our care.
The best thing any Floridian can do during hurricane season is preparing well before storms make landfall. Nursing centers are no different, and last year, FHCA began monitoring the path of Hurricane Irma early. This provided many of our centers ample time to complete important tasks to meet the needs of some 68,000 residents, such as boarding up windows with metal shutters, gathering 7-10 days of medication for each of our residents, and assuring that evacuation plans were in order.
Since then, our members have been hard at work on preparations for the upcoming season. Building on the lessons of 2017, nursing centers have strengthened their preparedness measures, working closely with local emergency managers to help them understand the complex circumstances and needs found inside a long-term care center.
Since the tragedy at the Hollywood Hills center, FHCA has worked closely with Gov. Rick Scott and the state to implement a workable new generator requirement. Our centers have cooperated with community preparedness officials to ensure that plans will better protect residents’ health and well-being and maintain their comfort in the event of a power outage, making sure local authorities understand the need to keep nursing centers a top priority for emergency services, including restoring power.
The goal is for every nursing center to be in compliance with the new requirements by June 1, the statutory deadline and first day of hurricane season.
However, it’s important to remember that centers can be considered in compliance either by having a permanent generator installed or by submitting a specific plan showing how they will ensure that residents will remain cool and safe if the power goes out. These new protocols are making Florida’s long-term care centers better prepared than ever before, and they are receiving outstanding cooperation from federal, state and local authorities.
The 2017 season carried some challenging lessons, and we have learned them well. As a result, we are more prepared than ever to keep our residents safe.
We know there’s no such thing as being overprepared, and we will do everything we can in the 2018 hurricane season to make sure our residents’ safety remains the top priority of FHCA members across Florida.
Emmett Reed is executive director of the Florida Health Care Association.