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2019 Florida Legislative Session Halftime Report: Health Care, Budget Battle, and More


The start of April marks the halfway point of the 2019 Florida legislative session. For weeks legislators have been working on a budget while advancing bills related to health care, education, transportation, and everything else impacting the lives of Floridians. Things are moving fast but here are some highlights so far.

Budget Battle

On March 3, the Florida Senate unanimously approved a $90.3 billion proposed budget for the 2019-20 fiscal year. The House passed it's $89.9 billion budget proposal two days later. Both proposed budgets are less than Gov. Ron DeSantis’ $91.3 billion proposal. The leaders of the two chambers will now negotiate to create a single final budget before legislative session ends on May 3.

The House and Senate budget plans have key differences. On education, the Senate wants to increase the Florida Education Finance Program by $1.1 billion, while the House proposed a $579.3 million increase. On health care, the Senate plans to redistribute $319 million in hospital funding from 29 facilities with the largest Medicaid caseloads to all facilities across the state. The Senate is proposing an across-the-board 3 percent Medicaid rate cut for hospitals

Leadership Priorities

When it comes to health care, House Speaker Oliva has been vocal about his desire to deregulate health care (Certificate of need) and introduce other reforms on the provider side of health care. Speaker Oliva and the House successfully passed a bill eliminating the Certificate of Need process, but the bill has yet to be considered in the Senate. Meanwhile, Senate President Galvano began legislative session by advocating for the use of Medicaid block grants. While this proposal has not been introduced, the Senate is moving forward with reducing Medicaid retroactive eligibility.

Prior to his election, Governor DeSantis was fairly quiet on health care, but his health care agenda is coming into focus with proposals on prescription drugs and transparency. He has supported a bill enabling the state to bring in medications from Canada to combat the high costs of prescription drugs. Governor DeSantis is also supporting publicly posting hospital prices and insurance rates online for state residents to use.

Unfortunately, Florida state leadership continue to reject Medicaid expansion, despite several bills being filed. Speaker Oliva and Gov. DeSantis have long opposed expanding Medicaid eligibility. They are now joined by the yet to be confirmed Agency for Health Care Administration Secretary Mary Mayhew. Mayhew had opposed Medicaid expansion when she was Maine health commissioner. However, last week she told a Senate committee that she won't stand in the way of a ballot initiative to expand Medicaid.

Concerns Over Confirmation of New Agency for Health Care Administration (AHCA) Secretary

The Senate is currently working to confirm Mary Mayhew as the permanent secretary of the Agency for Health Care Administration. She replaces Justin Senior as the head of Florida’s Medicaid program. On April 4, the Senate Appropriations Subcommittee on Health and Human Services recommended confirmation on a 6-3 vote. Mayhew's confirmation now moves to the Senate Health Policy Committee.

Florida advocates are concerned because as Maine’s Commissioner of Health and Human Services (2011-2017), Mayhew helped tighten eligibility standards for Medicaid and add restrictions to its food stamp and welfare programs. During that time, the state’s spending on safety-net programs shrank significantly and Medicaid enrollment declined.

Last week, AHCA proposed cuts for behavior analysts, who frequently treat children with autism. During her Senate confirmation hearing, Secretary Mayhew walked back those proposed cuts and also said that she won't stop a ballot initiative to expand Medicaid – despite opposing expansion during her time as Maine health commissioner.

Staying Updated on Health Care

Click here to use our Legislative Session Tracker to monitor the progress of health care bills moving through the legislature.

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