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Diagnosis For 8.16.22: Checking The Pulse Of Florida Health Care News And Policy

Medicaid expansion, which has long been a no-go in Florida and as well as other states controlled by Republicans, is starting to get a renewed look in other states that have been holdouts.

Axios Atlanta reported Monday that some Georgia Republicans have “quietly changed” their minds about Medicaid expansion for a multitude of reasons, including the fact that the federal government has not cut back on the 90% of guaranteed funding for those eligible for Medicaid expansion.

Another noteworthy moment is that Medicaid expansion is under serious consideration in North Carolina, which, like Florida and Georgia, was one of the states that recently expanded to one year of Medicaid postpartum coverage. The expansion was allowed under the American Rescue Plan.

Democrats have long been arguing for the need to expand Medicaid and the two Democrats running for Governor, Agriculture Commissioner Nikki Fried and U.S. Rep. Charlie Crist are advocates for expanding coverage to the working poor. Without a Medicaid expansion, they are left without coverage because they do not earn enough income to enroll in the federal health insurance exchange and don’t qualify for subsidized coverage.

They may not agree on everything, but Charlie Crist and Nikki Fried take the same stance on Medicaid expansion.

There was a (brief) moment in Florida when the GOP-controlled Florida Senate considered a form of expansion. But for several years now, the Florida Legislature has blocked the idea.

Right now, Florida is one of 12 states that opted against expanding Medicaid after the U.S. Supreme Court ruled in 2012 that the federal government could not withhold funding to those states that did not expand coverage. The ruling came in a lawsuit filed by NFIB and championed by the state attorney general’s office.

Most of the states that have opposed expansion have been in the South, including Texas and Tennessee. However, Wisconsin, Kansas, Wyoming and South Dakota also have not expanded Medicaid.


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— Big changes? —

It’s not often that Pharma takes a hit.

But that’s exactly what happened after the passage of the Inflation Reduction Act last week.

The measure is being described as the largest health care reform since passage of the Patient Protection and Affordable Care Act. While Medicare won’t be authorized to begin negotiating for drug costs until 2026 there are other provisions in the inflation Reduction Act regarding pharmaceutical costs that kick in sooner.

A big hit to Big Pharma.

Beginning this year pharmaceutical manufacturers who hike drug costs above the rate of inflation will face financial penalties. In 2023, the bill limits co-payments for insulin to a maximum of $35 per month in Medicare Part D, the prescription drug benefit covered by Medicare. The Inflation Reduction Act also ends co-payments on Part D-covered vaccinations in 2023.

In 2024, premium increases for Medicare Part D are capped at 6% annually. In 2025, out-of-pocket drug costs for Medicare Part D will be capped at $2,000.

And in 2026, Medicare can start negotiating the top 10 most expensive drugs taken at home and on the market for at least nine years without competition. Those drugs which can be negotiated will increase by 15 in 2027 and (eventually) reach 20 additional drugs annually.

AARP Florida thanked U.S. Reps. Kathy Castor, Sheila Cherfilus-McCormick, Crist, Val Demings, Ted Deutch, Lois Frankel, Al Lawson, Stephanie Murphy, Darren Soto, Debbie Wasserman Schultz and Frederica Wilson for supporting the legislation.

In a statement, AARP Chief Executive Officer Jo Ann Jenkins reacted to the vote:

“Today is a momentous day for older Americans. By passing the Inflation Reduction Act, Congress has made good on decades of promises to lower the price of prescription drugs. Seniors should never have to choose between paying for needed medicine or other necessities like food or rent, and tens of millions of adults in Medicare drug plans will soon have peace of mind knowing their out-of-pocket expenses are limited every year.

“Many people said this couldn’t be done, but AARP isn’t afraid of a hard fight. We kept up the pressure, and now, for the first time, Medicare will be able to negotiate with drug companies for lower prices, saving seniors money on their medications. “I thank the House members whose votes today will bring real relief to millions of Americans, and I look forward to President Biden signing this bill into law.”

Democrats need to decide whether they take the victories in the Inflation Reduction Act or whether they try to push to lower the costs of prescription drugs for people enrolled in individual health policies or group policies. A move to cap at $35 the co-payment charged to commercially insured patients was unsuccessful.

The Inflation Reduction Act also continues through 2025 the enhanced subsidies that help with rising health insurance premiums for health care plans bought on the federal health insurance exchange. According to the Kaiser Family Foundation, subsidies are saving people $700 annually on their premiums. Had they not been extended, people’s premiums would have skyrocketed by 53%.

— More money, more projects —

Gov. Ron DeSantis signed a record-high $110 billion spending plan for the current fiscal year 2022-2023 but that hasn’t stopped lawmakers from wanting to spend a little bit more.

Included in the FY 2022-2023 budget is a $205 million pot of money in the new state budget to fund local projects, of which about $125 million will go to one-time payments for essential workers. That leaves the Legislature with about $80 million for what is referred to as “local support grants.”

As they say: Mo’ money, mo’ appropriations. Image via AP.

Lawmakers sent 971 local funding requests that totaled nearly $844 million by the deadline. A Florida Politics search for local funding projects that included the words biology, biological sciences, cancer, diabetes, doctors, health, health care, hospitals, nurses produced 70 submissions worth more than $38.8 million.

Examples of health-care-related local projects for consideration include:

$2.6 million request by Rep. Wyman Duggan for a pediatric behavioral health unit at Wolfson Children’s Hospital;

$750,000 by Rep. Jay Trumbull for Jackson County for its hospital district renovation;

$500,000 for Calhoun Liberty Hospital (also submitted by Trumbull) to connect water and sewer to the proposed new hospital site;

$1,450,202 by Rep. Robert Andrade for a geriatric behavioral health care unit at Baptist Hospital;

$1.2 million request by Rep. Joe Harding for renovations to SMA’s Marion County’s behavioral health campus; and

$500,000 by Rep. Tom Fabricio for South Broward Hospital District to construct and equip a pediatric simulation room at Memorial Hospital in Miramar.

It’s not clear when the Joint Legislative Budget Commission will meet to discuss the local funding requests but the 2022-2023 budget requires that it approve requests no later than Sept. 15. The Executive Office of the Governor must submit a budget amendment no later than Sept. 30 to distribute the local support grants to the appropriate agencies to distribute.


The post Diagnosis for 8.16.22: Checking the pulse of Florida health care news and policy appeared first on Florida Politics – Campaigns & Elections. Lobbying & Government..

FloridaPolitics, excerpt posted on  SouthFloridaReporter.comAug. 16, 2022

Republished with permission 

This article originally appeared here and was republished with permission.


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