ORLANDO, Fla. — Health care was one of the biggest issues in the 2024 legislative session, culminating in the passage of the Live Healthy initiative aimed at addressing the state's health care worker shortage and fostering innovation.
Gov. Ron DeSantis signed components of the package Thursday at a news conference in Bonita Springs. He signed five bills, the most notable of which is SB 7016, which invests $716 million in training and retaining the state's health care workforce.
“We are taking steps to strengthen our health care workforce to keep pace with our state’s unprecedented growth,” DeSantis said. “I commend Senate President Passidomo for his dedication to this cause, which helps position Florida as the freest and healthiest state in the nation.”
Legislation passed this session would make it easier for out-of-state doctors to obtain licenses, pay their student loans, treat HIV, and more.
But reforms passed this year still leave an estimated 789,800 Floridians without health insurance. Many Democratic lawmakers pushed to address this issue by making Medicaid expansion part of the Live Healthy package.
Florida is one of 10 states that has chosen not to accept federal funding to expand Medicaid eligibility to low-income childless adults. Before the pandemic, an estimated 415,000 Floridians were in a coverage gap because they earned too much to qualify for Medicaid but too little to qualify for supplemental care.
A review of 151 studies by policy analysis group KFF found that expansion reduced uninsured patients and improved hospital profits, especially in small and rural hospitals. Studies also suggest that expansion could save the state enough money to break even or completely offset the cost of expansion.
But for Passidomo, it wasn't a starter.
“Medicaid expansion is not going to help,” she told reporters earlier this month, continuing that Florida does not have enough health care providers to treat more Medicaid patients.
Here are some of the most impactful changes made this year, as well as some proposed changes that didn't come to fruition.
Increase the number of doctors and receive training
A shortage of doctors and nurses is a major problem in Florida, with older doctors retiring and younger doctors leaving the state. Passidomo said resolving that is a top priority.
Live Healthy allocates $150 million to increase physician training programs and expand physician slots across the state in graduate medical education. The goal is to provide incentives for doctors and dentists to stay in Florida after completing their training, as well as pay for training spots for 500 new doctors.
The bill would also remove barriers for foreign-trained doctors to practice and teach in medical school in Florida, among other measures to attract more doctors to Florida.
Additionally, SB 7018 establishes a Healthcare Innovation Council within the Florida Department of Health to provide financing for projects aimed at improving Florida's healthcare and filling gaps created by shortages.
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The 15-member council will receive $50 million in non-recurring funds each year and $500 million over 10 years.
Nursing unions, including National Nurses United, say that while increasing education is important to increase the state's supply of health care providers, working conditions need to improve to prevent nurses from burning out and leaving the profession. I have long argued that there is.
The bill, sponsored by Sen. Iliana Garcia (R-Miami-Dade), would establish minimum staffing levels for certified nurses in Florida and provide whistleblower protections. Her bill, “SB 376: Providing Patient Protections,” was struck down without being read.
mental health issues
The nonprofit organization Mental Health America ranks Florida 46th in the nation for access to mental health care. These standards include access to insurance, treatment, special education, and workforce availability.
The state needs 587 more mental health providers to meet the need, according to U.S. Department of Health and Human Services calculations.
One of the largest investments in the Live Healthy package, SB 330 provides $321 million to create a new model of care and education for Florida's behavioral health system by establishing a “Behavioral Health Teaching Hospital.” We have allocated $1,000,000.
Existing teaching hospitals can earn the designation by partnering with universities, developing workforce development programs, and offering specific behavioral health education programs. Florida officials plan to provide $300 million in subsidies to these hospitals over the next three years.
The Live Healthy package also reduces barriers for psychologists and psychiatric nurses to work in Baker Act facilities and provides mobile response teams in each county to reduce unnecessary emergency hospitalizations due to Baker Act and mental health crises. We are earmarking $11.5 million in ordinary general revenue for the expansion.
An additional $8.2 million is earmarked for reimbursement for health care models that integrate physical and behavioral health care. Integration is an approach approved by the American Psychological Association and supported by numerous studies.
HIV prevention
Florida has the highest HIV infection rate in the nation, with approximately 5,000 new cases diagnosed each year over the past decade, a significant decline in the state even as the U.S. has declined by 8% over the past decade. has not been seen. Thousands more are thought to be infected with HIV and not know it.
HB 159/SB 1320 aims to prevent more people from contracting sexually transmitted diseases by authorizing certain pharmacists to screen for HIV exposure and prescribe and distribute post-exposure prophylaxis (PEP). I am. PEP is a drug that can prevent HIV infection after exposure to HIV. within 72 hours.
Currently, to receive PEP, you must go to your primary care physician, emergency room, or urgent care facility. The bill awaits the governor's signature.
The original bill, which would have allowed pharmacists to prescribe pre-exposure prophylaxis (PrEP), which reduces the chance of contracting HIV by 99%, was removed.
cancer research
This year's budget tripled the state's investment in the Florida Cancer Innovation Fund, established in 2023, to $60 million. Projects the foundation has funded to date include research into biomarkers to detect pancreatic cancer and efforts to increase early detection of breast cancer in rural women.
The budget also added $1.2 million to the Mary Brogan Breast and Cervical Cancer Early Detection Program, bringing total funding for the program to $3 million. This program funds breast and cervical cancer screenings for uninsured women with incomes below 200% of the poverty line.
Meanwhile, attempts to make breast cancer diagnosis more affordable for women through insurance have failed. HB 773, sponsored by Rep. Marie Paul Woodson (D-Hollywood), would have required insurance to cover follow-up breast cancer testing at no cost. Follow-up diagnostic scans can cost anywhere from $234 to more than $1,000 out-of-pocket, said Susan G. Komen.
A companion bill, SB 932, Coverage for Breast Diagnostic and Supplemental Examinations, would eliminate cost-sharing only for state employees. It passed unanimously in the Senate, but was rejected in the House.
people with disabilities
The CDC estimates that 4.5 million adults in Florida have some type of disability. The bill signed Thursday, SB 1758, would expand services for many of these Floridians.
This bill adds an online application process for applying for government services and shortens the time it takes to determine eligibility.
The big change is that people with disabilities will be able to use their allocated monthly budget to purchase long-term care services that meet their needs.
Maternal health management
SB 7016 provided $23 million to expand a telehealth minority maternity care pilot program to all 67 Florida counties. The program was successfully piloted in Duval and Orange counties in 2022. In 2023, the program was expanded to an additional 18 counties, receiving more than $12 million.
SB 7016 would also allow “advanced birth centers” to perform C-section deliveries for women with low-risk pregnancies. Currently, birthing centers are not allowed to perform C-sections. It would also allow these birth centers to serve Medicaid recipients. However, these centers must have written transfer agreements with nearby hospitals to accept patients in case of emergency.
The Live Healthy package also invests $134 million to increase Medicaid reimbursement rates for hospital workforce and delivery services. Maternity wards are often seen as a loss for hospitals. In recent years, 20 hospitals in Florida have closed labor and delivery units, creating obstetric care deserts in some counties.
Another bill, HB 415, gives the Florida Department of Health $466,200 to develop a website to share public and private resources for pregnant women and parents. The bill passed, but DeSantis has not yet signed it. Democrats unsuccessfully tried to pass an amendment that would require websites to include medically accurate information about abortion and contraception.
health check
Live Healthy creates an online portal for health care providers that promotes free or low-cost tests and services so that Floridians can find those services in their area. We are also seeking the cooperation of county health departments to facilitate this portal.
Nonprofits can receive grants to expand their health care delivery capacity by starting new medical screenings and services or mobile clinics or units.
Biomarker testing
HB 885 would require Florida Medicaid and state employee health insurance plans to cover biomarker testing, an initiative promoted by groups such as the American Cancer Society Cancer Action Network and the Alzheimer's Association. There is. This requirement does not apply to private insurance.
Biomarker tests measure biological changes that indicate whether someone has a disease or is at risk of developing a particular disease. Research is underway to establish biomarkers for many of Florida's leading causes of death, including Alzheimer's disease and most types of cancer. Biomarker tests can also provide insight into which treatments are best for cancer patients.
The bill passed Congress and was sent to DeSantis for his signature.
