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Insurance Consumer Advocate

Sha'Ron James


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Mailing: 200 East Gaines St.
Tallahassee, FL 32399-0308

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(850) 413-3089
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Florida makes strides in health-care reform

News Article

April 26, 2016

Orlando Sentinel

Washington's passage of Obamacare dealt a major blow to small-business owners and their ability to provide cost-effective health care to their employees, but it was successful in doing one thing: forcing Florida to emerge as a hub of health-care reform. Health-care policy is alive and well in Florida, and much progress was made during this year's legislative session to improve the effectiveness of the system and help control costs for Florida's consumers and businesses.

The transparency of pricing in the health-care system received a major upgrade, as a priority of Gov. Rick Scott succeeded in holding hospitals more accountable. House Bill 1175 essentially gives consumers more freedom of choice by setting up a website to allow the public to view and compare services and prices at public hospitals prior to seeking treatment. This type of transparency in pricing increases competition between facilities and reduces the likelihood of overcharging.

Transparency in general is a quality that the health-care industry has desperately lacked, and the passage of this bill will surely put power back into the hands of consumers and drive down health-care costs.

Balance billing was a big threat to Florida's consumers, and this year the National Federation of Independent Business successfully advocated for reforms that will help protect vigilant Floridians from victimization. Often, after doing their due diligence and seeking treatment at an in-network facility, an individual is seen by an out-of-network specialist working at the in-network facility. Under this alarming practice, consumers were being hit by surprise medical bills ranging from hundreds of dollars to tens of thousands of dollars or more after being unknowingly treated by an out-of-network provider. Balance billing was already illegal for patients with HMO plans, and NFIB successfully worked to pass legislation this year to ban it for PPO plans.

Legislation like improving pricing transparency and banning surprise billing is exactly the type of policy that states can pursue to blunt the negative impacts of Washington's control over health care. States have the power to develop meaningful health-care policy, and Florida can and will continue to lead the charge to improve costs and outcomes for Floridians. The way to do this is to enhance doctors' connections with consumers — finally putting patients' relationships with their doctors first — by freeing doctors from grips of insurance companies and big pharmaceutical companies.

One of NFIB's top priorities on the health-care horizon does just that. Direct primary care, the latest in innovative health-care delivery, allows business owners to contract directly with primary-care physicians and pay a manageable monthly retainer to provide primary-care services to their employees. The savings for business owners would be huge, and for much less money than it would cost to embark on traditional health insurance policies, they could connect more employees with better primary care. It's so simple, you'll wonder why it isn't authorized yet.

This new approach is already being practiced by primary-care doctors in Florida, but they operate under the pall of potential regulation. NFIB is leading the charge to clarify that these arrangements are not classified as health insurance. This will open the door to allow even more physicians to offer these discounted services to business owners.

We'll also be working against proposals that abandon step therapy, or "fail-first," cost-containment measures that help keep insurance costs down by requiring doctors to try generic drugs first. These anti-business proposals are classic examples of big pharmaceutical companies wielding power over the health-care system. We plan to fight to preserve doctors' abilities to do their jobs rather than following the mega-marketing dollars of Big Pharma that drive costs up on small-business owners.

Small-business owners consistently say that their biggest challenge is providing cost-effective health insurance to their employees. At NFIB, we're committed to finding ways to not only make health care more affordable, but to reform the health-care system to increase efficiency and remove fraud and victimization.

We've worked at the federal level for years, advocating for real changes, offering solutions and encouraging Congress to pursue reforms. But now it's Florida's turn, and we're encouraged by the progress being made to improve doctors' connections with patients and enhance health care as a whole.

Small-business owners and their employees deserve it, and our state deserves the right to be at the forefront of making it happen.