Peter Schorsch
House Bill 221 is not only a sorry excuse for addressing the issue of balance billing, it’s also exactly what voters find so frustrating about politicians who campaign saying one thing while doing the exact opposite once they’re safely behind locked Capitol doors.
The latest example comes from Rep. Carlos Trujillo. As a candidate, Rep. Trujillo told voters he opposed Obamacare. It is true he has supported high-profile (yet meaningless) efforts to oppose Obamacare — efforts like a 2011 constitutional amendment to the voters (CJR-2) to exempt Florida from provisions of Affordable Care Act.
Yet curiously, this year he’s pushing legislation that could have been copied out of the federal Obamacare health law.
Likely thinking that no one is paying attention and in the end, conservatives will vote Republican no matter what, other Obamacare opponents are endorsing this measure.
Take Chief Financial Officer Jeff Atwater. With a potential U.S. Senate primary in his future, there’s no doubt he will express a desire to repeal Obamacare. Then why is he supporting this effort to codify parts of the controversial federal law in Florida statutes?
Trujillo and Atwater aside, it’s certainly not the first time politicians have said one thing to the voters and done another thing in office. It’s this kind of behavior that has voters so angry and disappointed with the “Party establishment.” But this proposal is far from the meaningless vote taken on the constitutional amendment in 2011. This bill would have a tremendous impact on patients and their families.
The bill reinforces, emboldens and protects the shoddy, narrow-network plans that have proliferated under the language in Obamacare. These are the same plans that are forcing people to change their doctor even if they like their doctor and sorely limiting access to care.
The bill has drawn supporters such as the Florida Association of Health Plans. Yes, the big-time HMOs are embracing HB 221 saying it relieves Preferred Provider Organizations policyholders from often large, unfair and unexpected medical bills after emergency care from an out-of-network provider.
That’s nice feel-good spin but it’s not the full story. The smiling, devious Devil is hiding in the details.
Under current law, balance billing of Health Maintenance Organizations patients is banned, but HMOs are required to have significantly broader and more inclusive networks. What supporters leave out is that under HB 221, smaller, narrow-network PPOs would get the same protections as HMOs without changing network standards.
These PPO plans seriously limit a consumer’s choice and access to the health care they want and when they want it. That is truly unfair.
If narrow-network PPOs want similar protections for policyholders that HMO policyholders receive, perhaps they should take on more robust networks standards.
HB 221 essentially lifts the rate-setting structure from Obamacare and applies it to a larger swath of people. It is precisely what many in the Florida Legislature have fought against over the past several years with Obamacare.
Various other options could be taken to protect the consumer from unexpected bills — without ripping words from the pages of the train wreck of a federal health care law.
Free-market, less-government, more freedom supporting legislators could force insurers to pay the balance bill in its entirety; or set up an arbitration process between the provider and insurer to determine a fair amount to be paid for services provided out of network; or perhaps insurance regulators could strengthen network adequacy standards, making it less likely an insured individual would end up using an out-of-network provider in an emergency.
For now, judging by who wants to push this idea into law, it seems insurance companies that had a hand in making Obamacare a reality at the federal level also have a hand in HB 221.
