Charlie Crist's vow to change Florida law about insurance regulation during a Facebook Q&A on Aug. 6 was not liked by the Republican Party of Florida.
In answer to a voter's question, Crist said he would reinstate the state insurance commissioner's power to renegotiate 2015 health insurance rates in time to keep costs down.
"The fact that we have a law on the books under Rick Scott that says the Office of Insurance Regulation can't regulate insurance is astounding," Crist said. "We deserve better, you deserve better."
But the state Republican Party contradicted him. "Wrong, Charlie," the GOP's Facebook account wrote. "It's Obamacare that prevents OIR (the Office of Insurance Regulation) from regulating insurance … a law that you think is great even though premiums will go up by double digits for Floridians."
Is the party right that the Affordable Care Act stopped Florida from regulating insurance?
The 2010 Affordable Care Act said states had to follow minimum federal guidelines for insurance plans, like requiring that pre-existing conditions be covered. The health care law also required insurance companies to justify unreasonable rate increases, defined as more than 10 percent year over year.
The Florida Legislature decided that if the federal government wanted a say over policy premiums, then it could go ahead and regulate it itself. In May 2013, Scott signed SB 1842, a law that suspended for two years the requirement that insurers get state approval for rates for new plans. The bill took away Insurance Commissioner Kevin McCarty's power to negotiate rates or refuse rates deemed too high. Insurance companies still had to file rate changes with the state, but could institute those changes without approval. Republicans passed the bill largely along party lines.
But the Affordable Care Act doesn't give the federal government power to regulate insurance rates. It defers to states to regulate their premiums, following a set of criteria for state agencies.
Ironically, the Republican Party of Florida told us it was referring directly to the portion of the Affordable Care Act that says state law is to be followed unless it contradicts the federal health care law, and that's why Obamacare makes the insurance commissioner obsolete when it comes to setting rates.
Experts we talked to said that doesn't mean Washington can or wants to do Florida's job.
"If a state doesn't have rate review authority, then no one really has the power to review them," Washington and Lee University law professor Timothy Jost, who supports the law, told us. "If Florida can't do it, then no one can."
Jost said the federal government does have some power over insurers in Florida. It can ask insurance companies to explain big rates hikes, then deny the companies the ability to sell in that state if the government chooses. The company would have to disclose to policyholders and potential customers it had been reviewed for unreasonable rates, an undesirable distinction. But that's not the same kind of power that a state has to regulate health insurance directly, he said.
Florida is unique in its unwillingness to let its own agency to do its job, said Greg Mellowe, director of health research and analysis at the Florida Center for Fiscal and Economic Policy, a consumer health advocacy group. "The intent of Obamacare was to keep states in charge of regulating insurance," Mellowe said. "Instead, the Legislature changed state law to take away Florida's rate review."
Washington even offers states grants to assist in strengthening rate review powers, a program in which Florida has refused to participate.
For 2015, 14 insurance companies have filed plans for rate increases averaging 13.2 percent, although three companies said their rates would go down next year. While those are preliminary proposals, the state has no power to negotiate to lower the premiums until next year, thanks to the 2013 law.
The U.S. Health and Human Services Department points to states like New York and Oregon as examples of states that actively keep premiums low through rate reviews. Since 2010, other states have started or are planning to enact stronger insurance regulations to enforce the health care law's rules.
So the state GOP not only misrepresented the terms of the law, but it also implied it was to blame for the state's (temporary) regulatory woes. And it was mostly Republican lawmakers who spearheaded change to Florida law after the state rejected a $1 million federal grant to help improve the process.
Most other states regulate insurance rates without the difficulty the Republican Party of Florida claimed. We rate its statement Pants on Fire!
Edited for print. Read the full version at PolitiFact.com/Florida.