Tallahassee Update Week Two

Week Two Update:

Medicaid expansion: When key committees in both houses declined to accept Medicaid expansion, it seemed a death knell to this historic initiative. But the Senate, in the form of Sen. Joe Negron, then proposed an alternative plan that would essentially accomplish many of the same goals of expansion (covering more than a million low-income Florida adults) that would hopefully qualify to get the federal billions attached to healthcare expansion. The House, unfortunately, is taking the stance that they don’t want the federal money. Gov. Scott said he’d likely support the Senate plan. We’ll need to keep the pressure up over the next few weeks.

Pensions — The legislature continues to work to fix what isn’t broken. HB 7011 was passed by the State Affairs Committee, with a caveat that it wouldn’t affect certain classes of people, such as the disabled. Still bad, though. Meanwhile, SB 1392 passed Government Oversight and Accountability, headed for State Affairs, and SB 534 also passed that committee on a party line vote.

Week One:

Ah, Tallahassee in the first promise of spring…it’s like a Fellini film as reimagined by George Lucas. Yet, the fate of many Floridians on important issues such as health care, pensions and voting rights hangs on the spectacle of elected officials making deals at lightening speeds.

Each week, we will update you on several issues we are engaged in and offer opportunities to get involved in pushing legislation in the right direction.

 Pensions: Several bad bills have been proposed to gut state and local pension systems in various ways.

  • HB 7011 would prevent new state employees from entering the pension system, shifting them instead to a 401K. Not only is this a solution to a problem that doesn’t exist (FRS is funded at a robust 87%), by closing the system to new hires, the pension fund would slowly shrivel and die, leaving retirees with a busted fund just when they were counting on it. This bill has sailed through various committees on party line votes. It will hit the State Affairs Committee next, before moving to the floor of the House. The Senate version of this bill aims at local pensions, which would affect police and firefighters, among others.
  • SB534 proposes to change the valuation method for local and municipal pensions (originally that included state pensions too, but it got taken out in committee). The whole point of this sneaky bill is to make pensions look like disasters that must be strangled in their rocking chairs.

 Affordable Care Act (ACA) and Medicaid Expansion: This debate is rife with complexity and has all the “No, he didn’t!” plot twists of a Friday night telenovela.

The evidence is pretty clear that fully implementing ACA and Medicaid expansion has a lot of upside for Florida — more than a million more low-income residents able to access quality health care, billions in federal funding, thousands of new healthcare jobs.

But the Republican-controlled House and Senate committees charged with making recommendations on this issue (Select Committee on the Patient Protection and Affordable Care Act) both rejected Medicaid expansion in the last week – instead expressing a preference for a hodgepodge system of vouchers and private insurers that they have yet to define. It’s a dangerous game because some lawmakers are betting that they can reject federal conditions of expansion, while still somehow getting the billions of dollars that go along with it.

As healthcare providers, we don’t care what they call the expansion of quality health care for the masses of working poor who power Florida’s economy (and who we see every day in our emergency rooms because they can’t get basic primary care). We just want them to do it and do it right. Don’t play games with the health of our patients.

Other healthcare issues we’re working in Tallahassee include changes to funding formulas that will greatly impact Jackson Health System’s ability to sustain itself, and a safe staffing bill to require hospitals to ensure patient safety through adequate staffing ratios.

Funding issues that affect Jackson include the DRG (Diagnosis Related Group), which is how the state reimburses hospitals for Medicaid services. The formula is being changed from per diem to per procedure. We need to ensure that the formula they use doesn’t penalize teaching hospitals like JHS, which has higher costs. We also want to ensure that funding for uncompensated care doesn’t decrease during ACA implementation.

Safe Staffing and Patient Handling: Local 1991 worked with legislators to get two important bills filed on this perennial issue.

  • HB 1397/SB 1732 (props to Rep. Kevin Rader and Sen. Oscar Braynon for filing!) would mandate nurse staffing ratios in every unit of every hospital in Florida.
  • HB1383 (thanks Rep. David Richardson!) would mandate certain safe patient handling procedures.

Elections, Ethics and Campaign Finance Reform: Remember last year’s various voting and ethics fiascoes created by bad legislation? We’re trying to fix that.

  • HB 7013 passed the House last week. It would restore the number of early voting days to 14, expand early voting hours and sites and limit the length of ballot summaries. SB 600 is the Senate version and we like it better because it is stronger and offers more protection of our basic right to vote.
  • SB2 makes it a little harder for lawmakers to engage in the kind of activity for which they are often criticized by the general public. Specifically, conflict-ridden dual employment and the use of CCE’s by lawmakers. HB569 would eliminate CCEs and raises campaign contribution limits to $10,000 (gulp), while SB1382 kills the CCEs and caps contributions at a more reasonable $500 per candidate per election.