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Fla. Republicans defend hands-off approach on federal health care

Health and Human Services Secretary Kathleen Sebelius, center, speaks about the implementation of the Affordable Care Act at a stakeholder meeting Monday in Houston. Sebelius has said she was “baffled” by Florida’s lawmakers’ actions in giving up the state’s power to regulate insurance rates.
Published Aug. 20, 2013

TALLAHASSEE — Republican lawmakers are fighting back against criticism that their hands-off approach to the federal health care law is leaving consumers vulnerable.

And they reject accusations that the law preventing the state from regulating health insurance rates for two years was based on faulty or misleading information.

"We had thorough hearings on it. The rationale for the bill was explained thoroughly during the committee process," said Rep. John Wood, R-Winter Haven, who sponsored the bill in the House.

Democrats and consumer groups raised red flags but were unable to dramatically alter Senate Bill 1842, which passed with most Democrats and just one Republican voting no. Gov. Rick Scott signed it into law in May, but a recent PolitiFact ruling cast a spotlight on the bill.

PolitiFact pointed out that Florida had forfeited its ability to regulate rates for plans listed on the health exchange even though the federal government doesn't have the power to deny rate increases.

U.S. Health and Human Services Secretary Kathleen Sebelius said last week that she was "baffled" by the state's actions. She said she didn't know of any other state that relaxed its oversight and that most were beefing up insurance regulations.

"If lawmakers are saying that they knew what they were doing when they passed the bill, then they knowingly passed a bill that strips vital consumer protections and misleads Floridians," said Leah Barber-Heinz, spokeswoman for consumer group Florida CHAIN. "They hypocritically turned over the state's authority to regulate its insurance industry to the federal government, though they do not have the authority to do that."

Republican lawmakers are standing by their approach. There is still too much uncertainty around health care reform for the state to take responsibility for what happens on the exchange right now, they said.

"I think it was the right thing to do, and it gives the state of Florida breathing room as a very, very difficult and complex law is being attempted to be implemented," said Sen. David Simmons, R-Altamonte Springs, the bill's sponsor.

Even without state rate review, there are consumer protections in the health care law intended to prevent insurers from gouging customers.

For example, if companies don't spend at least 80 or 85 percent of premium dollars on direct medical care, they must issue rebates, a provision known as medical loss ratio. The federal government can kick plans off the exchange or brand a company's premiums "unreasonable."

But the feds don't have ratemaking authority, and the law didn't anticipate states suspending their rate approval functions as Florida has.

Sen. Eleanor Sobel, D-Hollywood, changed her vote on SB 1842 from yes to no because she got last-minute jitters about the relaxed regulations. She thinks the federal government should have created a rate approval process for policies on exchanges, but in the absence of that the state should have stepped up.

"The law is the 'affordable' health care act and we're not guaranteeing affordable at this juncture, so I'm not happy with the situation as it is," she said.

But Sobel is also at a loss about how to fix it now or even if anything could have been done when the bill was passed this spring. Florida refused federal grants that other states used to beef up their insurance oversight, and by the time the bill was up for a vote, lawmakers were focused on the budget and other priorities.

"It slipped through," she said. "It absolutely slipped through."

Contact Tia Mitchell at tmitchell@tampabay.com.

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