2013 Legislative Session
Update
Week Two
Affordable Care Act | Biomedical Research Funding | Cancer Care & Research | Clean Indoor Air Act | Cigarette Surcharge | Tobacco Education & Use Prevention | Tobacco Settlement
This second week of the 2013 Legislative Session was
quite busy and full of surprises and speculation, but for reasons other than a
packed agenda. State capital insiders were shocked by the sudden resignation of
Lt. Governor Jennifer Carroll. Although not charged with any crimes, she
resigned one day after racketeering and money laundering charges were brought
against a veteran’s charity group
called Allied Veterans of the World, to which Carroll and her public relations
firm provided services to the company in 2009 and 2010. The charity group
is linked to Internet cafe/gaming operations throughout the country..
Carroll has proclaimed her innocence of any wrongdoing; but resigned as she felt the investigation
would be distracting to Governor
Scott’s administration. The first African-American female Lt. Governor, Carroll
was a former Florida House member and Secretary of the Florida Department of
Veterans Affairs. She served 20 years in the U.S. Navy and retired at the
rank of lieutenant commander. Governor Rick Scott announced he would not name a
replacement until after the legislative session ends in early May.
Besides this surprise, there was speculation over the amount
of budget allocations to be made early next week for each of the legislative
appropriations subcommittees. Today, state economists will meet and update
their forecast on general revenue collections—a key estimate that forms the
basis for the budget committees to start the budget building process. The
revenue estimate will allow Senate and House leaders to set what are known as
"allocations,'' which divide up funding between the various parts of the
budget, like health care, education, transportation, etc.
Additionally, the week saw action ranging from legislation to ban texting while
driving and the use of unmanned drones by local law enforcement officials to
continued discussions on the expansion of the Affordable Care Act. Also,
the Gaming committees of both the House and Senate will consider a shutdown of
existing Internet cafes and a moratorium on any new operations in Florida.
Following is a summary of the priority issues for the
American Lung Association in Florida:
Florida Clean
Indoor Air Act: SB 258 / HB 439
No movement this week
SB 258 by Senator Rob Bradley (R-Orange Park) and HB 439 by Representative Bill Hagar (R-Boca Raton) amend the Florida
Clean Indoor Air Act to allow cities and counties to restrict outdoor smoking
on municipal and county property.
SB 258 was amended to limit where non-smoking areas
can be placed and requires the designation of smoking area within those
non-smoking areas. The restricted areas, as well as designated smoking areas,
must be identified by signs. The bill also provides for enforcement.
There was no committee action this
week on SB 258. The bill will be heard next by the Community Affairs Committee.
HB 439 has not been scheduled for hearing yet in its first committee of
reference, the Health Quality Subcommittee.
The American Lung Association in
Florida raised concerns that the newly-amended proposal is not strong enough to
protect public health.
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No movement this week
Current law imposes a surcharge of $1 per pack on
standard sized cigarettes. SB
620
by Senator Jeremy Ring (D-Margate) and HB
473 by Representative James Waldman (D-Coconut Creek) create the “Youth
Smoking Prevention Act” and increase
the surcharge on standard sized cigarettes from $1 to $2 per pack, with
non-standard sized cigarettes being taxed proportionately.
There was no committee action this week on SB 620
or HB 473.
The American Lung Association in Florida supports
increasing the cost of cigarettes as a strategy to reduce youth smoking and
encourage people who smoke to quit.
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Statewide Tobacco Education and Use
Prevention Program
Waiting on budget allocations
Florida’s
Constitution requires the Legislature to annually appropriate 15 percent of
funds paid under the tobacco settlement for tobacco education with an annual
adjustment for inflation. After the Governor unveiled his budget
recommendations and priorities on January 31, and then during the February
interim legislative committee meetings, the Senate Appropriations Subcommittee
on Health and Human Services chaired by Senator Denise Grimsley (R-Sebring) and
the House Health Care Appropriations Subcommittee chaired by Representative
Matt Hudson (R-Naples) heard presentations by staff from the Governor’s Office
of Planning and Budget on those budget recommendations. The Governor’s budget
recommends full funding of the Comprehensive Statewide Tobacco Prevention and
Education Program at $65,605,793. Specifically, the line item allocations are
as follows:
State
& Community Interventions.............................$10,630,288
State
& Community Interventions - AHEC..................$5,320,738
Health
Communications Interventions.......................$22,724,400
Cessation
Interventions..........................................$12,663,790
Cessation
Interventions - AHEC................................$7,213,826
Surveillance
& Evaluation.........................................$5,731,550
Administration &
Management..................................$1,321,201
Last week, Senate Appropriations Chair Joe Negron
(R-Palm City) announced that he anticipated that Senate President Don Gaetz
(R-Destin) would give budget allocations to the budget subcommittees this week;
however, no allocations were released. Once the allocations are determined, the
budget subcommittees, including the Senate Appropriations Subcommittee on Health
& Human Services and the House Health Care Appropriations Subcommittee can
begin their work in earnest.
The American Lung Association in Florida is
working to ensure the allocation of these dollars follows CDC’s Best Practices for Comprehensive Tobacco Control, are
competitively procured, and rigorous performance measures are included in any
contracts managed by the Florida Department of Health.
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Biomedical Research
Funding
Waiting on budget
allocations
During
the 2012 Legislative Session, the Legislature appropriated $18 million for
biomedical research. From these funds, the Legislature carved out $2.5 million
in nonrecurring general revenue (GR) funds and $5 million in recurring funds
from the Biomedical Research Trust Fund to both Shands Cancer Hospital and the
Sylvester Cancer Center at the University of Miami. They also provided $3
million in GR funds to the Department of Health and the Sanford-Burnham Medical
Research Institute to work in conjunction to establish activities and grant
opportunities in relation to biomedical research.
In
his 2013 budget recommendations, Governor Scott proposed restoring funding to
the Florida Biomedical Research Grant programs by eliminating these direct
appropriations to specific institutions and using that money to fund the
peer-reviewed competitive grants of the King and Bankhead-Coley programs at $15
million each. The Governor also proposed modifying the programs slightly to
more tightly focus on particular cancers that affect Floridians, as recommended
by the Cancer Control and Research Advisory Board (C-CRAB) and the Biomedical
Research Council (BRAC), and would set goals and metrics for both the Board and
the Council to monitor. He would also promote closer collaboration among
research institutions.
The American Lung
Association in Florida supports a comprehensive, independent peer-review
process to determine the recipients of research dollars.
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Tobacco Settlement — Nonsettling
Manufacturers: SB 252
No movement this week
SB 252, re-filed by Senator Thad Altman
(R-Melbourne), requires
more cigarette makers to pay the state as part of its settlement with tobacco
companies. The measure has been pushed unsuccessfully for several years. The
interest earned from the settlement fund provides health care to children and seniors. Supporters of the bill include RJ Reynolds
Tobacco Company and the Altria Group.
No action on this bill this week and still no House
companion has been filed.
The American Lung Association in Florida is
monitoring this bill.
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Quality
Cancer Care & Research: SB 1660
Initial hearing on proposal this week
SB 1660 by Senator Anitere
Flores (R-Miami) establishes a Cancer Center of Excellence Award for providers
that excel in providing cancer care and treatment in this state, requires the
Florida Cancer Control and Research Advisory Council (C-CRAB) and the Biomedical
Research Advisory Council (BRAC) to jointly develop performance measures, a
rating system, and a rating standard in accordance with specified criteria for
applicants to qualify for the award, and provides that an award-winning cancer
provider is granted preference in competitive solicitations for a specified
period of time, and authorizes endowments under the William G. “Bill” Bankhead,
Jr., and David Coley Cancer Research Program for establishing funded research
chairs at research institutions. Funding will be dealt with separately
as part of the appropriations bill. A House committee bill addressing this issue will
likely be filed in the House.
SB 1660 was
discussed and voted out of the Senate Health Policy Committee on March 14. Senator
Flores indicated to committee members that the proposal is a work in progress
and “sort of” the Senate’s version of the Governor’s cancer care proposal. She
solicited input from the stakeholders and the community on how to make the bill
better. The bill appears to be on somewhat of a fast track as it has been
placed on the agenda of the Children, Families, and Elder Affairs Committee for
March 18.
The American Lung Association in Florida is
monitoring this bill and any potential House committee proposal.
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Affordable Care Act
Implementation
Senate committee rejects federal plan and wants
“third option”
One
of the largest policy debates in decades involves how Governor Rick Scott and
legislative leaders decide how Florida will implement the federal Patient
Protection and Affordable Care Act (PPACA). The two major PPACA-related policy
issues to be decided are whether the state will expand its Medicaid population
and whether Florida will pursue a state, federal or partnership-based health
exchange model for consumers to purchase health care.
The
Senate Select Committee on the PPACA voted to reject what they
called a “federal plan to expand Medicaid” in order to pursue a “third option”
to deliver health care insurance to uninsured residents. Republican senators on
the select committee argued that Medicaid is a broken system and that it makes
no sense to enroll more people.
Committee
Chairman Joe Negron (R-Palm City) outlined five principles to guide
implementation of a PPACA provision to provide health care to the
uninsured. Senator Negron wants to:
- Build upon the Florida Healthy Kids program, which
provides health insurance coverage through private insurers to children in
households earning up to 200 percent of the federal poverty level;
- Include copayments so there is cost sharing;
- Feature a health savings account so that healthy
behavior is rewarded; and
-
Do away with what he calls the “disparaging
language of Medicaid” that connotes dependency on government rather than
individual ownership.
“Health
Care for Florida Now” held a rally and
press conference at the capital this week calling for access to quality,
affordable health care for all Floridians.
Also this
week, the Florida Hospital Association held a
press conference on the steps of the Old Capitol asking the state to move
forward with Medicaid coverage expansion. The House Select Committee on PPACA cancelled
its meeting this week. This would have been the Select Committee’s first
meeting since they voted to reject Medicaid expansion on March 4.
The
PPACA calls for providing coverage to people living in households earning up to
138 percent of the federal poverty level, about $16,000 for an individual and
$27,000 for a family of three. Currently, a single parent with two children
must earn less than $9,000 to qualify for Medicaid.
An estimated 365,164 uninsured
adults in Florida have chronic obstructive pulmonary disease or asthma. Many of
these patients will be eligible for Medicaid coverage in 2014 if Florida
expands health care coverage under the Affordable Care Act.
On
the issue of health exchanges, for at least the first year of PPACA, the
state has already chosen to default to a federally-run online site where people
shop for insurance and see if they qualify for federal subsidies. The
state will reassess the issue after the first year to determine if a state-run
exchange or a state-federal partnership model makes more sense in the future.
The
American Lung Association in Florida supports expanding access to health care
services for these vulnerable Floridians.
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We hope this brief legislative update is helpful. We will keep you posted on these and other developments as the 2013 Session progresses.
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