Florida Health Insurance Advisory Board recommends deductible health credit transfers and insulin cost caps to legislature

Last Wednesday, the Florida Health Insurance Advisory Board (FHIAB) voted unanimously to send a set of policy recommendations developed by Florida Voices for Health to the state legislature for consideration in the 2023 legislative session.

 

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The 8 consumer policy recommendations were presented to the FHIAB by Florida Voices for Health Program Director and FHIAB board member Louisa McQueeney at a meeting in September. 

Some of the key policy recommendations approved by the board include the allowance of deductible health credit transfers between health plans, as well as the state protecting consumers from prescription drug formulary changes during a policy year, and the state requiring individual and group health insurance policies to cap the cost of insulin drugs.

One policy recommendation included in the set is for the state to allow deductible health credit transfers. Florida Voices for Health recommends the state allow insured patients to switch health plans mid-year and receive credit for out-of-pocket payments they have already made to the prior insurer.

“With the continual rise in annual health insurance deductibles to consumers, having to start a new deductible in the middle of the year creates financial hardship,” Florida Voices for Health stated about this recommendation. 

“When consumers change health insurance plans outside of the Open Enrollment period, because of an employer changing plans outside of annual renewal, or a change of employer, or a change in geographic area, or loss of employer coverage and purchase individual coverage, annual deductibles start all over again even if a consumer has met part or all the accumulators out of their own pocket.”

Another policy recommendation included in the set is for the state to require providers to provide one free copy of their own medical records via mail or electronic mail at the time the provider requests payment for services provided. 

“Many requests for records are not honored in a timely fashion if honored at all and some at great expense to the consumer,” Florida Voices for Health explained. “Obtaining one’s own medical records is especially important when disputes arise with insurance companies, resulting in denial of claims, leaving patients in precarious financial positions. This in turn should lead to lower health insurance costs to both plan sponsors and individuals.”

Another policy recommendation is for the state to prohibit insurance carriers from changing or removing a covered prescription drug during the policy year. Florida Voices for Health said this recommendation comes largely as a response to insurance carriers making changes to their drug formularies during the policy period in recent years.

“Insurers routinely reclassify drugs to [better] access restrictive drug tiers, increase the consumer’s co-payment, coinsurance, or deductible, and reclassify drugs to higher cost sharing tiers. There are also instances of certain drugs being dropped from coverage altogether. Consumers are then informed by mail that they will be financially responsible for the entire cost drug in the middle of the policy year.”

An additional policy recommendation included in the set is for the state to require individual and group health insurance policies to cap the insured person’s monthly cost-sharing obligation for covered prescription insulin drugs at $35 beginning in 2023. 

Florida Voices for Health emphasized that this cost cap would significantly decrease the cost of healthcare for Floridians. 

“The Inflation Reduction Act, recently signed into law, will reduce the cost of insulin to no more than $35 per month for people on Medicare starting 2023. This includes insulin pumps. However, the new law doesn’t extend to individual and group health plans. The cost of insulin, which has been around for 100 years, is 10 times higher in the US than any other developed country and creates an enormous financial burden on Floridians who cannot survive without.”