5 Things Florida: 2021 legislation, Vaccine rollout, Medicaid enrollment

Welcome to our inaugural edition of 5 Things We’re Watching in Florida health care and health policy. These are topics we think are worth keeping an eye on for senior health care executives and health policy leaders. I hope you’ll find some value in this.

I’d welcome any feedback you have for this once-per-month newsletter. It’s free, and will remain so. It’s funded entirely through the support of our 2021 Florida State of Reform Health Policy Conference. That’s coming up in May, which we will have more about in the months ahead. Until then, here are a few things worth tracking in Florida health care for January, 2021.





With help from Emily Boerger

1. Vaccine distribution off to rocky start

Vaccine distribution in Florida was initially mired by inefficiencies and system failures. As of Wednesday, Florida has received 1.15 million doses of the COVID-19 vaccine and of those received, 339,032 (29%) have been administered. On Tuesday, Florida was in the bottom 10 states in terms of percent of doses used according to a New York Times tracker, but has since improved to 29th in the country.

A high demand for vaccine appointments has resulted in crashed websites, clogged phone lines, and senior citizens spending the night waiting in line for their shot. On Monday, Gov. DeSantis announced Florida will work to increase the number of state-supported vaccine sites, to hire 1,000 contract nurses to support vaccination efforts, and identify locations in underserved communities to administer vaccines.


2. Health bills teed up for 2021

Looking ahead to Florida’s 2021 legislative session, lawmakers in the House and Senate have already pre-filed several health-related bills. Among the bills we’ll be watching in the House is HB 29 which would allow hospitals to dispense a limited supply of medicinal drugs to hospital patients in emergency circumstances, and HB 83 which would deem peer specialists an essential element to recovery from substance use disorder or mental illness.

Meanwhile, Sen. Lauren Book has championed a “pro-women-and-girls legislative agenda” which includes the Learning with Dignity Bill to combat what is known as “period poverty.” Book is also sponsoring  SB 238, which would extend Medicaid coverage for postpartum care.


3. Health provisions in federal spending bill

In his latest piece, State of Reform Columnist Jim Capretta outlines some of the most significant health-related provisions in the 5,593-page year-end spending bill President Trump signed last week. He highlights the $58 billion in added funds for the public health response, surprise billing restrictions, Medicare pay boost for physicians, and the delay in the resumption of the Medicare sequester.

In Florida specifically, the $900 billion COVID-19 relief package will provide additional unemployment assistance, a new round of stimulus checks (which many Floridians have already received), and it may help businesses continue to pay employees through a new round of funding to the Paycheck Protection Program. Over 42,000 companies in Florida received $150,000 or more in loans through the PPP program last year.


4. Committee agendas now posted

The schedules are up for next week’s legislative committee meetings and we have our eye on several. On Wednesday the Senate Health Policy Committee will meet for a discussion on the state’s COVID-19 mitigation efforts by the Agency for Health Care Administration and the Department of Health. The Appropriations Subcommittee on Health and Human Services will also meet on Wednesday. On Thursday, the Select Committee on Pandemic Preparedness and Response will host a hospital panel discussion and will hear an update from State Surgeon General Scott Rivkees, MD.

In the House, the Health and Human Services Committee is scheduled to convene on Thursday along with the Pandemic & Public Emergencies Committee. The Children, Families, & Seniors Subcommittee is also scheduled to hold a meeting on Wednesday to provide an implementation briefing on SB 1326, related to child welfare.


5. Medicaid enrollment expected to peak

Florida’s Social Services Estimating Conference expects a total Medicaid caseload of 4.4 million individuals in fiscal year 2020-21, well above its previous peak of 4 million individuals in 2016-17. Due to the uncertainty surrounding COVID, the caseload is expected to grow to 4.6 million individuals in FY 2021-22 then decrease to 4.5 million in 2022-23 and 4.4 million in 2023-24.

The Conference estimates this enrollment jump will require an 18.7% increase in program expenditures, growing from $26.6 billion in FY 2019-20 to $31.6 billion in FY 2020-21. Thanks to federal assistance, economists say Medicaid will have a $342.8 million surplus in general revenue funds this fiscal year, but that is expected to change to an almost $1.25 billion shortfall in FY 2021-22 without supplementary federal funding.