Opinions – Page 5 – Florida Politics

Joe Henderson: Chris King’s interesting idea for ‘bullet tax’

The proposal floated by Democratic gubernatorial candidate Chris King to tack an extra 6 percent tax on ammunition and gun sales in Florida has a lot of merit – which means it has little or no chance of becoming law.

(We’ll pause here momentarily to allow the National Rifle Association and its supporters to regain their composure).

The idea, which King unveiled last week in St. Petersburg, sounds similar to the way states approach cigarette sales.

If you can’t stop ‘em, the state can at least impose what King called a “safety fee” to pay for gun usage programs and so on, including all medical costs for victims of mass shootings.

He also would divert the current sales tax revenue on weapons and ammunition to what he calls “The Every Kid Fund For Gun Violence Prevention.”

“ … every child deserves to grow up in a state free from the scourge of gun violence, whether it’s everyday gun violence or mass shootings,” he said in a statement.

Not buying it?

Well, look at what has happened with Florida’s approach to tobacco.

According to tobaccofreekids.org, Florida generated $1.1 billion from cigarette taxes in fiscal year 2016. In the same year, Florida’s youth smoking rate was the lowest in the nation at 3 percent in 2015 – a 71 percent decrease in the first 10 years since voters overwhelmingly approved the creation of Tobacco Free Florida.

People can still smoke if they’re willing to pay for it, but smoking-related health care costs have been reduced by more than $3 billion.

Apply that logic to ammunition sales, and what would we have?

Law-abiding citizens could still buy ammo and guns, and isn’t that what defenders of the Second Amendment are always most concerned?

But just as smoking (or not) is a choice, so is gun ownership (or not) and arguments could be presented that might make someone question if buying a weapon is really the best way to ensure personal safety.

Yes, the NRA offers gun-safety programs — and that’s good.

But that comes with the assumption that a person has already decided they want a gun. And I think King’s basic argument is built on the premise that maybe we have too many of those floating around already.

While we’re on the subject, the Giffords Law Center noted that Florida is kind of loose when it comes to ammo sales.

There is no minimum age to buy or possess ammunition, impose a minimum age or license requirement for the purchase or possession of ammunition.

Sellers don’t have to keep records of who buys their product, and there are no safe storage requirements or restrictions on where they can be sold.

It should be noted that King has vowed to take no money from the NRA in his campaign, although I doubt that will a problem since I can’t imagine single penny from that organization would be earmarked for him anyway.

King has vowed to push for such things as universal background checks on all gun sales, including private ones, and a ban on the sale of assault weapons. He also has advocated Medicaid expansion to make more mental health services available.

Good ideas, both.

But the tax idea earned the headline.

The First Amendment talks about the right to life, liberty and the pursuit of happiness — and that often conflicts with the Second Amendment’s clear intent that people have the right to own guns.

King’s idea might be a way to bridge that gap until the time when people realize that a good guy with a gun is not the only way to stop a bad guy.

Julio Fuentes: Florida lives depend on naloxone co-prescriptions

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.

In 2016, more than 4,000 Floridians fatally overdosed on opioids. Fortunately, in 2016 Florida also passed a law allowing health care practitioners to provide naloxone to patients, caregivers and first responders. This life-saving, overdose-reversing drug kept our death toll from being much higher.

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.

Opioid-related fatalities among Hispanics increased by more than 50 percent between 2014 and 2016.

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.

Joe Henderson: Gwen Graham makes stand against conversion therapy quackery

So-called “conversion therapy” is only a thing because a segment of wingnut nation considers it a sacred duty to force its values on everyone. The practice goes on because too many lawmakers look the other way.

But it’s not therapy at all, at least as reasonably educated people understand the practice. It is, instead, medieval quackery on par with bloodletting and lobotomies.

What it does have is a high chance of inflicting real harm on someone who dares to be who they are.

It is outlawed in 12 states, and while Florida doesn’t have a blanket ban it is prohibited in 19 municipalities — including Tampa, Miami, and Palm Beach County. As Florida Politics reported, Democratic gubernatorial candidate Gwen Graham said Legislature should extend that ban to the entire state.

She is correct.  

Conversion therapy seeks to force, er, “convert” gay and transgender people into becoming straight people. What possibly could go wrong?

It usually is linked to conservative religious zealots, not to be confused with many mainline evangelicals who simply believe homosexuals may be born that way but can fight the “temptation.”

Because homosexuality it is not considered a disorder by the American Psychiatric Association, treatment to “correct” that not only lacks scientific backup, it can actually be harmful to the person being “corrected.”

The so-called therapy can include electroshock treatments to induce seizures and memory loss, maybe so the one being “treated” will forget what vile people did that to him or her. It relies on basically brainwashing the treated person into hating themselves enough to “change.”

As Saul Levin, the APA’s Chief Executive Officer and Medical Director, American Psychiatric Association, noted, “(the treatment) does come bundled with a real group of potential risks, including depression, anxiety, and self-destructive behavior.”

This “therapy” is not a new thing, but it gained increased attention when the Republican Party platform in 2016 tiptoed up to the edge of what many believed was an endorsement of the practice, declaring “right of parents to determine the proper medical treatment and therapy for their minor children.”

The key word — “therapy” — was seized upon by LGBTQ groups, but party officials denied there was any connection.

But it is a fact that many conservative Christians have a tough time separating the biblical declaration that homosexuality is a sin from the rights of people under the secular law. That may help explain why two attempts by Democrats to push through a law banning conversion therapy through the Legislature got nowhere.

Alas, even if Graham wins and becomes Governor, Democrats will be pressed to have enough legislative muscle to get this past Tallahassee Republicans. She could always try an executive order, as she hinted in a tweet, but opponents could challenge that in court.

Some conversions are a bridge too far, you know?

After all, can’t upset the base by endorsing science.

Joe Henderson: FEA to Republicans: You get an F, and you get an F, and you …

It seems only fair that the Florida Education Association decided the Legislature deserved to be covered with the same sauce it has for years been ladling on public schools.

Hence, the report card the Association just gave lawmakers, based on how they voted on education issues over the last two years. Not surprisingly, Republicans — aka the Charter School Expansion Rubber Stamp Collective — fared poorly.

I can just picture Oprah Winfrey announcing the outcome: “You get an F! And you get an F! And you …”  

In the Senate, 16 of 24 Republicans were given F’s, along with most of the GOP House members. This is not surprising, for two reasons:

1: Richard Corcoran, who served as House Speaker for the last two years, was hellbent to overhaul public education in Florida. He made huge strides in that direction, supremely confident that he knew what was right and making sure members of his caucus understood that.

Public-school teachers and union members generally loathe him. I don’t think he minds.

2: While public-school teachers for years have known the deck is stacked against them in the Legislature, they appear to realize that demoralized acceptance of the disrespect from Tallahassee isn’t a winning a strategy.

The primary argument in favor of charter schools is that they offer students stuck in failing schools an alternative. Actually, that is true. Some students do extremely well in charters, but it doesn’t tell the whole story.

Public schools must accept any student — whether disruptive or disinterested. Nothing is (or can be) demanded of parents in terms of school participation. And if the students flunk out, it can drag down the whole school’s grade, under a formula determined by the state to punish teachers.

Charters can enact much stricter rules and require support from parents. At Tampa’s Brooks-DeBartolo Collegiate High School, for instance, families must spend at least 20 hours each year in some volunteer service there.

Public schools don’t have that option.

Failure to meet that requirement means, according to the school handbook, means the student can be expelled. Excessive tardiness or absences can get a student kicked out.

Not so in the public schools, unless a student is 16 years or older.

You get the idea.

Charter schools can boast of some impressive numbers; Brooks-DeBartolo perennially gets an “A” rating and seems by any standard to be a success story.

But charters can also cap enrollment — this case, around 600 students — while public schools have to take any student living within their boundaries.

Teachers at charters also are not unionized.

That always has been the issue, I believe, for lawmakers. They hate dealing with the teachers’ union.

So, they fought back the best way they know how — with grades, to show how public schools lag, with ridiculous requirements that set some schools up for failure, and by diverting money to the charters.

Charter schools this year received more than $91 million from the state under a capital funding program enacted in 2017.

And the FEA told lawmakers if you want to play that game, OK, here’s your grade.

I doubt few, if any, F-rated Republicans are worried about that, any more than a Democrat who gets the same rating from the National Rifle Association stays awake nights.

In our ultra-polarized atmosphere, politicians now wear rejection from the other side as a badge of affirmation.

But there should be at least a little warning to Republicans, used to running roughshod in the Legislature.

Between shootings on campus and being on the receiving end of the back of lawmakers’ hands, they have had enough. If enough of them follow the NRA and take this report card to the polling place, it might just tip a few seats.

If that happens, the FEA will no doubt award itself an “A.”

Mark Wilson: Consumer Protection Coalition warns Floridians to beware of AOB abuse this hurricane season

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.

Blake Dowling: Oops

Technology can be your best friend and your worst enemy. Have you ever “replied all” to an email when you meant to reply just to the person who sent it to you? Has your phone ever pocket dialed your high-school sweetheart or the FBI?

The “oops factor” in tech is always looming, so make sure you are always diligent with your devices and treat your tablet and phone as sacred.

Also, remember your devices have a mind of their own.

Tech industry leaders like Elon Musk have been warning us that artificial intelligence will take over the world if we are not careful. I think we have a few college football seasons ahead of us before global apocalypse happens but in the meantime, AI is wreaking some havoc. How about Alexa sending out a private conversation between two people to one of the person’s contacts without their knowledge. That happened. The “smart” device heard a series of words within the dialogue that lead it to take several steps. 1) Record the conversation and then 2) send it to a contact. Mind blown.

The potential for scandal, disaster, embarrassment and hilarity are off the scale here.

So, while you chew on that, let’s also look at the other most common part of tech that is infested with oops: social media.

We have seen a renaissance in social media use the past couple of years. It seemed to me that a couple of years ago the worlds of Twitter, etc. had calmed down a little but man then the gloves came off in a big way, especially around the time of the last election.

People, especially politicians, started unloading on Twitter, attacking their enemies, defending their agendas, etc.

Even with all this raw content sometimes people have a “hmmm” moment and delete something.

Not so fast my friends.

There is an entire website devoted to the publication of deleted tweets from your fave politicians. It’s called Politwoops.

According to the site, Sen. Bill Nelson deleted this May 26 after posting it for two hours. I don’t see anything too threatening, and Alan Williams is cool, so who knows why this got deleted. But it did.

You can check out all fun for yourself here, I narrowed it down to just Florida.

So remember to treat your tech like the powerful tool it is and it can be your pal.

Also, give those posts some thought before posting as people are always watching. A lot of you out there might have someone to review your posts for you before hitting the enter button. This is a superb system of checks and balances. Consider putting this into play, especially if you work in the hypersensitive world of state, local or federal politics.

Lastly, considering unplugging those smart devices when they are not in use. As we are starting to see, they aren’t really that smart yet and they could accidentally open you up to a world of hurt by emailing private conversations to everyone you know, in theory.

Have a great week.


Blake Dowling is CEO of Aegis Business Technologies. He can be reached at dowlingb@aegisbiztech.com.

Joe Henderson: State’s medical marijuana fight is past point of silly

At some point maybe 10 or 20 years from now, the contortions used by the state of Florida to stall the use of medical marijuana will probably seem pretty silly.

Eventually, the drug 72 percent of voters approved for use by people suffering such hideous diseases as HIV, Parkinson’s, multiple sclerosis, amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease) will be loosened from political reefer madness.

Those suffering from terminal diseases or just chronic pain will be able to smoke it, or even inhale!

That goes for the federal government too, which still bans marijuana use for even medical treatments.

Thanks to some political parlor tricks in May 2017, medical marijuana is available only in processed forms like oil or edible.

Opponents, probably hearkening back to the days when they didn’t get invited to the cool parties back in college, attached a ban on smoking medicinal weed.


Because the Florida Legislature often doesn’t give a rat’s patootie what voters really want.

That’s still happening, by the way.

After Leon County Circuit Judge Karen Gievers last week lifted that absurd ban, correctly calling it unconstitutional, Gov. Rick Scott quickly announced the state would appeal.

That opened the door for Orlando high-powered attorney and foremost MM advocate John Morgan to call on Scott to stop the madness.

“Rick this type of meanness will COST you the US Senate seat,” Morgan tweeted.

And for emphasis, he added, “Don’t be like the others. Grow some brass ones!!”

It shouldn’t take brass ones to deal fairly with this. After all, the soon-to-be-former Governor and U.S. Senator-wannabe be would be siding with 72 percent of voters.

I’m betting that when most of those folks voted yes on the medical marijuana amendment, they did so with the expectation that users in dire need of relief would be smoking the weed, which is said to be the most efficient way to obtain relief.

At some point, all this begs the question: Whose side is the Governor on?

The Legislature has done some pretty snarky things over the years, but this was essentially an upraised middle finger on an issue that should be about compassion.

I had an aunt die of Parkinson’s years before medical marijuana became a thing.

Ever seen somebody with that disease?

One of the last times I spoke with her, I could barely make out her words, but I sure understood the desperation in her voice. She was begging for something, anything, to help.

What would the Governor have said to her?

Sorry lady, but smoking medical marijuana might be bad for your health?

My grandmother died the most painful way you can imagine, her fingers curled up from rheumatoid arthritis. Every part of her body was in agony. She was begging for death to come.

Pain is always somebody’s problem until you personally experience the real thing.

We’ve seen the crisis in this state and nation from opioid addiction. It’s legal to prescribe potent painkillers like Oxycontin and Vicodin, and they work well; oh yeah, they work. But they carry a horrible risk of addiction that can kill.

Would smoking medicinal weed be worse than that?

This is past the point of silly.

There is a time to stop being a politician and start being human.

I think we’re there.

Joe Henderson: Voter poll is a chapter, but full story is yet to come

The latest voter survey by Public Policy Polling — the one showing Philip Levine with a double-digit lead in the race for the Democratic gubernatorial race — is interesting and should be taken seriously.

His strategy of blanketing the airwaves seems to be working, although it would be more impressive if the primary was held in early June.

But it’s a long game (just ask the Houston Rockets what it means to be ahead at halftime). Toward that end, over lunch the other day, a friend was saying nice things about Adam Putnam, having met him a few times. That is welcome news to him, I’m sure, considering recent events.

But then, my friend casually asked who was running on the Democratic side. I said, well, there’s Philip Levine — he used to be mayor of Miami Beach.

I got a quizzical if-you-say-so look.

Well, and there is Gwen Graham. Remember U.S. Sen. Bob Graham? That’s his daughter.

Um, no. No clue.

At that point, I didn’t bother to mention Andrew Gillum or Chris King.

Now, my friend is older, smart, only peripherally interested in politics but will turn out to vote.

That is the kind of voter Democrats are going to need if they have any realistic hope of regaining the Governor’s Mansion in November. To many folks, though, their efforts have been a tree falling in the forest.

It’s not for a lack of trying.

They’ve all been out on the campaign trail, meeting with every civic or political group (or fundraiser) that will offer an audience.

Only Levine has been peppering the TV airwaves with commercials though, especially the one where he says public school teachers deserve a $10,000 annual raise.

I did some quick math on that.

There are about 180,000 public school teachers in Florida.

That works out to about $1.8 billion in extra money the state would have to find to make Levine’s wish come true even if he becomes the next Governor.

If you believe that will happen, fly to Vegas immediately and put it all on the Tampa Bay Buccaneers to win the Super Bowl next season.

It’s a message that Levine is planting in voters’ minds, though.

I mean, it’s never bad to be on the side of public school teachers; they are the firewall between us and a future straight out of a zombie apocalypse. 

They should be paid accordingly.

It’s fair game, though, to ask Levine exactly how he would plan to do that.

And since during a debate he fumbled over the question of how much money the state budgeted this year for public education (along with each of Democratic competitors), I think the devil might be in the details on this one.

The good news for Levine is that it’s probably too early for the vast majority of voters to care about details, or platforms, or even to get serious about knowing candidates who might as well be from the planet Zortron for all they know.

After all, they are competing for attention with seismic stories like the cancellation of the Roseanne Barr show on TV after her racist (but predictable) Twitter meltdown.

So, polls show Levine with a big lead. It shows Rick Scott leading Bill Nelson.

Interesting? Sure.

But what’s all mean?

Three words: Hillary. Rodham. Clinton.

After all, we are about three months away from the primaries and more than five months from the general election.

Candidates who are way behind should be aware and maybe a little concerned. But anyone in the lead probably shouldn’t start thinking about measuring drapes for their new office just yet.

Joel Griffith, Jonathan Williams: Supermajority requirement for tax hikes gaining steam for good reason

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.

Audrey Brown: Ending balance billing practices by air ambulances in FL

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.

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