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Legislature’s hands-off health care approach failing


Published:   |   Updated: September 13, 2013 at 09:22 AM

The Legislature’s decision to strip the state’s Office of Insurance Regulation of its authority to negotiate the lowest possible insurance rates has caused the uncertainty surrounding Florida’s health care costs. This bill slipped through committee with most members not aware that the federal government had no authority to negotiate health insurance rates in Florida.

Mistaken assertions that the federal Patient Protection and Affordable Care Act is the cause of increased insurance rates and the uncertainty in the health care market were long ago put to rest. The Affordable Care Act has been in effect for more than three years. During that time health insurance premiums have had lowest annual increases we have seen in more than a decade, even while the act expanded coverage and created benefits.

Still, the Office of Insurance Regulation projected premium increases on the health care exchanges that are part of the Affordable as high as 35 to 40 percent. These numbers have been roundly dismissed by the Florida Center for Fiscal and Economic Policy. They are strikingly similar to the state’s initial projection that Medicaid expansion would cost Florida $26 billion when in reality it was closer to $2.6 billion

Given the premium subsidies available on the health care exchanges, or marketplaces, individual premiums may drop as much as 7 to 10 percent, compared to current costs and small business premiums of as much as 18 to 20 percent.

To say that the Office of Insurance Regulation could not negotiate rates because of a lack of experience is exposed as a weak fabrication by the 11 states that have negotiated premium reductions for their exchanges, by an average of 18 percent.

In contrast Utah, which has taken Florida’s hands-off approach, has allowed premiums on its exchanges to rise higher than those outside the exchange. The result: a predictably low enrollment in the exchanges and a denial of health insurance to many low-income workers.

In addition, the Florida Legislature has steadfastly refused to pass legislation and accept federal assistance funding that would have prepared the Office of Insurance Regulation for this task.

The biased reporting on premium cost tells consumers the cost of the federal regulations but ignores the premium reductions those same regulations produce. Nor will there be mention of the essential health benefits those regulations or the Office of Insurance Regulation’s role would have.

While the U.S. Department of Health and Human Services has some control over premium increases because of other provisions of the Affordable Care Act, it cannot negotiate the lowest possible rates for Florida, as the Office of Insurance Regulation could have done if given the authority by Legislature.

This will leave Floridians with higher costs than they should have had, once again denying health insurance to many low-income workers. As we learned during the fight for Medicaid expansion, people without health insurance have a higher death rate, more bankruptcies and more disadvantaged children. Our Legislature should have done better by them.

Lawrence P. Floriani is an orthopedic surgeon in Tarpon Springs.

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