2010 Legislative Session: What Passed, What Failed in Life & Health?

While the omnibus property bill garnered most of the attention this past legislative session, there were significant life and health insurance-related bills under discussion also. A synopsis of what passed and what failed:

What Passed

The Florida Association of Health Underwriters (FAHU) predicted in January that the Florida Legislature would not be looking at serious market reforms due to the federal health legislation. That proved to be true. What did pass included minor tweaks to existing law and two separate measures aimed at prohibiting health insurance as a mandate.

HJR 37 by Rep. Scott Plakon (R-Longwood) is being tagged the "health-care freedom" amendment. If approved by 60 percent of the voters in the fall, then the constitutional amendment would allow Florida to opt out of the national health care plan.

HB 1143 creates a state statute that says no Floridian can be compelled to purchase health insurance. The legislation also contains a provision that gives Attorney General Bill McCollum firm standing in his federal law suit against the U.S. government. The language states in part that the Attorney General is authorized and has standing to sue on behalf of Floridians whose rights are infringed by the federal health-care reform. In late March, McCollum filed suit in federal court in Pensacola contending that the federal health-care legislation is unconstitutional and violates the amendment to the U.S. Constitution that preserves the states' individual powers.

HB 1143 also contains a highly controversial issue that may draw a veto from Gov. Charlie Crist. If enacted into law, HB 1143 would require a pregnant woman in her first trimester to have an ultrasound performed at her expense. The woman must be allowed to view the ultrasound while a medical professional explains the images. A woman can decline to view the images if she completes a form.

HB 885 addresses annuity training and clarifies that an agent who has not sold individual life insurance policies or annuity contracts during the continuing education cycle and does not have active individual life insurance policies or annuity contracts is exempt from the three hours of continuing education in suitability in annuity and life transactions. The agent may be required to submit a certification attesting to the eligibility for exemption.

What Failed

Many issues were introduced that never received serious consideration, including:

E SB 516/HB 275 Prescription Drug Insurance Coverage: Prohibited health insurance policies from denying coverage for prescription drugs based on formulary changes.

E SB 1122/HB 589 Minimum Loss Ratios: Required a minimum loss ratio guarantee of at least 85 percent for health insurance policies including Medicare supplement and long-term care insurance policies. This proposal was similar to the requirement in the federal health-care legislation.

E SB 2280/HB1191 Interstate Health Insurance Policies: Authorized for sale in Florida any health insurance product that is governed by the laws of any state, district or commonwealth of the U.S. The interstate health insurance policy would not be subject to form approval, rate approval, underwriting restrictions, guaranteed availability or mandates.

Mandates, Resolutions, and More

An expansion of the current autism mandate was the only filed mandate that garnered serious consideration this year. The annual mental and nervous disorder bill received one hearing each in the House and Senate but did not move further.

E SB 214 /HB 107 Autism: This expansion of the current mandate would include Down syndrome and cerebral palsy coverage. According to the Senate staff analysis, there are currently 309 children in the state with Down syndrome who would qualify for coverage. As with all mandates, FAHU opposes this expansion. Other bills that never moved forward include:

• SB 182/HB 7 Mental and Nervous Disorders
• SB 190/HB 111 Breast Cancer coverage
• SB 408 Craniofacial Anomalies coverage
• SB 936/HB 925 Breast Cancer early detection
• SB 2508 Colorectal exam coverage
• SB 1132/591 HIV Antiretroviral drug coverage

Florida Statute 624.215 requires individuals or organizations proposing mandates to have an economic and social impact statement prior to consideration. This statement is required to be submitted to the Agency for Health Care Administration and the Legislature. Since this statute was enacted, it has largely been ignored. Today we still do not have an accurate assessment of how much the current 50-plus health care mandates cost the consumer.

Medicaid Reform

Rising Medicaid costs currently devour approximately 20 percent of the entire state budget. Both the House and Senate had legislation designed to overhaul the state's Medicaid delivery system. The plans varied from an expansion of the current reform project in Broward and Duval counties to a statewide shift from the traditional fee-for-service method to a managed care system. A compromise could not be reached and both proposals died.

What's Next?

It is expected that Crist will call multiple special sessions this summer. Issues could include a proposal to constitutionally ban off-shore drilling and a discussion of renewable energy incentives. In the wake of the recent Deepwater Horizon oil spill, there is mounting political pressure to act. Health-care issues are not expected to be addressed at this time.

This past May, FAHU and others were asked by Florida Insurance Commissioner Kevin McCarthy and the Office of Insurance Regulation to participate at a hearing and to provide testimony on potential market disruption created by the federal health-care plan. This testimony will be delivered to the U.S. Department of Health and Human Services Secretary Kathleen Sebelius.

If Florida can demonstrate "significant market disruption" in the Florida individual/small group market, then the mandated 80-85 percent minimum loss ratio could be modified. There could be another public hearing in the near future and FAHU and other stakeholders will again be at the table.

Dave Sherrill is the executive director of the Florida Association of Health Underwriters. www.fahu.org.