The Florida House on Friday attacked and changed regulations that it says make it too expensive for people to see a doctor or go to the hospital.
Six bills passed Friday are the Republican-controlled chamber’s answer to rising — and often prohibitively expensive — healthcare costs. Their move comes one week after the House voted down a Senate plan to accept federal Medicaid expansion money to pay for insurance for poor Floridians.
Among the most significant changes contemplated under the House’s plan is a proposal to end the “certificate of need” program. Through certificates of need, the state regulates the number of hospital, nursing home and hospice beds, requiring approval for new facilities and expansions.
Getting rid of certificate of need (CON) requirements for hospitals will cut down on costly legal processes and allow the free market to determine where hospitals should be built or expanded, said bill sponsor Rep. Jason Brodeur, R-Sanford.
Supporters, calling the bill a “game-changer,” argue that cutting certificates of need will increase competition as it forces hospitals to lower their costs and increase the quality of their care if they want to survive.
“Our patients need access to heart surgery, they need access to emergency care, they need access to good quality care,” said Rep. Gayle Harrell, R-Stuart, said. “Eliminating the CON will open access in places where there isn’t.”
But Democrats, who opposed the bill in a 72-28 party-line vote, criticized the change and argued that eliminating certificates of need will discourage hospitals from opening in poor areas.
With state approval not required, hospitals would be drawn to open in more affluent areas, where there are fewer instances of unpaid bills and charity care, say opponents, including the Florida Hospital Association.
“I can’t imagine why a hospital would move to a low-income area or a rural area because those are areas where they are not going to get the same kind of return on their money,” said Rep. Lori Berman, D-Lantana. “Likely, this is just going to increase hospitals in affluent areas and not increase access to care.”
Supporters argue that 22 other states have eliminated certificates of need and not seen detrimental effects.
“The reasons not to vote for this bill is this parade of horribles that we haven’t seen in any other state,” Brodeur said. “It’s just unnecessary regulation.”
Another bill, more widely supported by members of both parties, would allow nurse practitioners and physician assistants to prescribe certain drugs. Currently, only doctors can do so. A third would extend the amount of time patients can stay at surgical centers to 24 hours and create a new kind of facility for surgical recovery.
House supporters say all the changes are intended to decrease the cost of healthcare and, in doing so, make it more accessible across the state.
“From the standpoint of driving down costs, that’s an important consideration that we should be looking at as legislators of this state,” Speaker Steve Crisafulli, R-Merritt Island, said. “And those initiatives, we believe, will do just that.”
Still, some lawmakers say the House missed its best chance at increasing healthcare access when it voted down the Senate’s health insurance subsidy proposal last week.
“This bill is really an end run around what we should be talking about, something that this House, at least, decided not to do, which is Medicaid expansion,” Democratic Leader Mark Pafford of West Palm Beach said.
The disagreement with the Senate could also present a problem for passing the House’s legislation into law. But Senate President Andy Gardiner, R-Orlando, said he is leaving the policies’ future to his healthcare committee, which will meet Tuesday.
“We are just focused on the policy,” Gardiner said. “Certainly there are a couple of those bills that the Senate has had some interest in, and I’ll leave it to the chair to make that decision.”
Herald/Times staff writer Jeremy Wallace contributed to this report.
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