Over 200 insurance agents, brokers and health professionals attended the “Florida Health Care Summit” on January 11, 2010, during which various panel discussions on the Florida impact of federal health care reform legislation carried the common theme of necessity for continued state control.

Florida Insurance Commissioner Kevin McCarty was among the speakers at the event. In his address, he noted that everyone shares a common goal of accessible, affordable health care, and that health care costs are approximately equivalent to 16 percent of the nation’s gross domestic product. Explaining his sentiment that the pending federal reform legislation does nothing to control the costs of health insurance, Commissioner McCarty said that the elimination of coverage denials for pre-existing conditions without addressing the inclusion of additional healthy individuals could have disastrous consequences. He also explained that the rating rules contemplated by the current bills could destabilize small provider pooling.

The president of a national health underwriters’ trade association also spoke at the Summit, during which he discussed the importance of broker services. A Washington representative of the association explained the pending federal health care legislation: Currently, a health care bill has passed both houses of Congress in different versions and is now being combined into one bill. Once it is released, each chamber will consider the single bill (“the bill”). According to the representative, the bill has significant negative impacts for small businesses. Thus, the tax provisions it contains are major negotiating points. The bill also includes federal mandates (such as loss ratios) that are cause for concern to many states, including Florida. The public option component appears to be a dead issue.

The Summit included several panel discussions moderated by Mike Vasilinda.

Carrier Panel

Rich Robleto, Florida Healthy Kids
Michele Robleto, Florida State Group Plan
Cindy Goff, America’s Health Insurance Plans
Mark Laborde, Aetna, President and General Manager Southeast
Chanta Combs, United Healthcare, VP Government Affairs
The panelists noted that effective health care reform must address affordability and accessibility. Reform, which is necessary to lower costs and expand coverage, should be done with incentives, flexibility and maintenance of local control. The current bill’s impact to the State of Florida includes adding new covered lives, such as part-time and other personal services employees. The cost of this would have to be shouldered either by states or employees.

Some of the differences in the House and Senate bills were discussed. It was noted that payment and liability reform, which could dramatically decrease costs, are two components that neither bill addresses adequately.

Business and Consumer Panel

Terry Butler, Senior Attorney, Office of the Florida Insurance Consumer Advocate
Jack McRay, AARP Advocacy Manger
Joan Galetta, insurance agent
Sally West, Florida Retail Federation
Josh Rubel, GE Healthcare
Mr. Butler commented that the bill contains many consumer-friendly provisions. The panelists suggested that many businesses would opt to pay the fine set forth by the bill for not insuring their employees, rather than insuring them. The panelists agreed that this would amount to pure waste. Further, information-sharing could increase the quality of patient care and make research data and medical history more assessable. Security of an individual’s medical history also is an issue of concern.

Provider Panel

Madelyn Butler, Florida Medical Association President-elect
Bruce Rueben, Florida Hospital Association, President
Jamie Wilson, H. Lee Moffitt Cancer Center Representative
Bob Asztalos, Florida Health Care Association
The bill’s impact from the provider perspective was discussed. It was noted that quality health care is not cheap. Health information technology was explained as an important part to health care reform, and that alternate forms of payment are not ready for general usage-a topic not adequately addressed by the bill. Further, the panel agreed that the Medicare reimbursement system is flawed and that the bill would create an access problem, which would ultimately equate to “sham” coverage.

Regulatory and Legislative Panel

Florida Senator Don Gaetz (R – Niceville)
State Representative Jimmy Patronis (R – Panama City)
Tom Arnold, Secretary, Florida Agency for Health Care Administration
David Foy, Deputy Chief of Staff, Florida Governor Charlie Crist
Mary Beth Senkewicz, Florida Deputy Insurance Commissioner
The Regulatory and Legislative Panel agreed that increasing health care access is a laudable goal. However, panelists felt that the bill inadequately controls costs, particularly the House version. According to Mr. Arnold, the State of Florida will have to appropriate $1 million to fund the bill’s mandates. A key question was debated regarding whether the state or federal government will control the bill’s administration.

Representative Patronis commented that “there is no silver lining,” nor any “one-size-fits-all” because each state is vastly different, and that individuals’ personal accountability is critical.

Senator Gaetz said that, in his opinion, the only positive aspect of the bill is that it addresses pre-existing conditions. He opined that the federal government should not be free to pass on massive mandates to the states.

Ms. Senkewicz stated that, in the wake of the bill’s passage, the overhaul of Florida’s medical system in Florida will be massive and require costly regulatory and legislative reforms.

In response to a question about Cover Florida, Mr. Foy noted that Governor Crist feels strongly about its implementation. Mr. Foy indicated that he is personally concerned that the bill would limit consumer choices. Mr. Foy added that the bill does nothing to address market competition.

Senator Gaetz predicted that a bill will pass sooner, rather than later. However, he said that a large portion of it will not become “institutionalized,” because he predicts that many of its provisions will be rolled back as a result of shifting post-election party majorities.

The Summit concluded following the regulatory and legislative panel.