Florida legislature ALMOST protects pre-existing condition coverage...but then undermines their own efforts

The bill started out on the right track...

Florida lawmakers approved a health insurance bill Wednesday that would require insurers keep covering pre-existing conditions if the Affordable Care Act disappears, though the bill would not keep protections in the federal law to control how much those patients can be charged.

...but quickly went off the rails after that:

The bill, Senate Bill 322, which the House approved by a 70-42 vote after the Senate passed it last week, would also expand short-term and association health plans and change requirements for “essential health benefits” covered by insurers, regardless of the status of the Affordable Care Act. It must be approved again by the Senate before it heads to Gov. Ron DeSantis for his signature.

The bill originally started as a proposal that would just require insurers and organizations that manage healthcare to offer at least one policy offering coverage regardless of a pre-existing condition. It also stipulated that the requirement would only go into effect if the federal law was repealed or struck down in court.

But the state Senate last week substantially amended the bill to tie it to the two other healthcare bills moving through the process as priorities of House Speaker José Oliva.

...But critics said the bill doesn’t have requirements that are in the Affordable Care Act to control prices on such plans and stop insurers from charging higher rates, and that changing the requirements for essential health benefits would weaken coverage. They also contended that the short-term and association health plans authorized by the bill don’t provide enough coverage and could siphon away healthy people with cheaper rates. That, they added, would increase the number of sicker people on other plans and cause premiums to rise.

(sigh) One more time: The ACA includes 8 major "Blue Leg" protections:

  • Guaranteed Issue
  • Community Rating
  • Essential Health Benefits
  • Minimum Actuarial Value
  • No Annual/Lifetime Benefit Limits
  • Maximum Out of Pocket Costs
  • No-Cost Preventative Services
  • Young Adults can Stay on Parents Plans until 26

Of these, the last two are the least important, and Florida already has a weaker state law letting young adults stay on their parents plans anyway (although it's only until they're 25, and they have to be both single and childless for whatever reason).

The first six, however, are very important...and from what I can tell, Florida SB322 only addresses the first one (guaranteed issue), while ignoring the others. Actually, it doesn't even do much on the guaranteed issue front: All it says is that one plan would have to be offered to anyone regardless of medical condition. The plan offered would presumably cost absurdly more than the rest of the carrier offerings.

In fact, it sounds like it might actually weaken the Essential Health Benefit provision, although I'm not sure what sort of requirements (if any) Florida had on the books for EHBs until now to begin with.

Even worse, it sounds like it's going to open the floodgates on junk plans in Florida, although, again, according to this analysis from the Commonweatlh Fund, Florida doesn't have much in the way of regulations or requirements for #ShortAssPlans to begin with.

Being required to let you buy an insurance policy (guaranteed issue) is pretty much useless if the carrier is allowed to charge you 20x as much because of your medical history, or your gender, or what you do for a living or whatever...and it's also pretty useless if they're allowed to deny coverage of the very conditions which you need healthcare coverage for the most.

Meanwhile, as noted in the article, further expanding short-term and association plans will simply result in more healthy people dropping out of the ACA risk pool, thus driving unsubsidized premiums up even further.

You were so close, Florida...