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Sen. Wilton Simpson. Image via Colin Hackley.

Influence

Lawmakers back access to pared-down health policies

Sen. Wilton Simpson said it will give more health-plan choices to people.

Insurers would be given the green light to sell scaled-back health insurance policies under a bill that the Florida Legislature passed Friday.

A priority for Republican leaders, the Senate voted 23-13 on Friday to give final approval to the bill (SB 322), which passed the House in a 70-42 vote on Wednesday. The bill is ready to go to Gov. Ron DeSantis.

The bill would allow short-term health insurance policies to be sold to individuals and groups. It also would allow for the establishment of “association” health plans. Short-term plans and association health plans are allowed under a pair of rules the Donald Trump administration issued as a way to blunt the federal Affordable Care Act, often referred to as Obamacare.

The short-term policies, renewable for up to three years, could exclude coverage of preexisting conditions and benefits such as hospitalization, emergency services, maternity care, preventive care, prescription drugs and mental-health and substance-use disorder services.

Senate bill sponsor Wilton Simpson, a Trilby Republican, called the legislation “comprehensive” and said it will give more health-plan choices to people.

But Jodi Ray, director of the group Florida Covering Kids & Families, said such choices can confuse people.

Ray said it’s difficult to understand the nuances of insurance policies. The problem with short term policies, Ray said, is that people don’t understand — despite the warnings — that the coverage isn’t comprehensive.

“I think it’s going to leave people at risk,” she said. “They are going to be at risk, and they really won’t understand that until something happens.”

The bill also would allow the establishment of association health plans, which allow small businesses, including self-employed workers, to band together by geography or industry to obtain coverage as if they were large employers.

One late change to the bill would allow businesses with fewer than 25 employees to establish multi-employer welfare arrangements. The so-called MEWAs allow employers to group and band together to offer employee health benefits.

Bill Herrle, executive director of the National Federation of Independent Business in Florida, said the bill “should make more options available to Florida’s small business owners.”

He noted that it was one of several market-oriented health bills that passed this year, a top priority of House Speaker Jose Oliva, a Miami Lakes Republican.

“Kudos to Speaker Oliva for leading this good health care ensemble of bills,” Herrle said.

House and Senate Democrats opposed the bill, which the Senate approved on the last full day of the 2019 legislative session. Lawmakers also will meet Saturday but are only expected to vote on the budget.

If DeSantis signs the bill, the sale of short-term insurance plans could take place immediately.

While the bill would allow insurers to offer alternative policies, it would also empower the Florida Office of Insurance Regulation to develop recommended changes to an “essential health benefits” benchmark used by the state. The bill would direct regulators to make recommendations by Oct. 30 on how the state could alter essential health benefits for Obamacare-compliant policies, effective January 2020.

Obamacare included 10 broad categories of coverage referred to as essential health benefits. They are ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

The federal rules allow states to select a new benchmark for essential health benefits in 2020. The legislation authorizes the Office of Insurance Regulation to begin that task.

While Florida Republicans have railed against Obamacare, some features of the law — such as protections for people with pre-existing conditions — are popular with Florida voters.

Prior to the federal law, the state did not have requirements that insurance companies and HMOs offer policies to people with pre-existing conditions. That means if the federal law is eliminated, people with preexisting conditions would lose coverage protections.

Simpson’s bill would make clear that if Obamacare is repealed by Congress or struck down by the United States Supreme Court, insurance companies in Florida would be required to offer access to health insurance.

The bill would require each health insurer and HMO to offer at least one policy to the hundreds of thousands of people who have pre-existing conditions. But Ray said access to health insurance isn’t the same as being able to pay for it.

“It’s not enough to just offer a plan,” she said adding, “it may be available, but you can’t afford them.”

The News Service of Florida provides journalists, lobbyists, government officials and other civic leaders with comprehensive, objective information about the activities of state government year-round.

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