TALLAHASSEE — When someone wants to build a new hospital in Florida or add beds in an existing health facility, the state has to agree that their community has a need for expanded health care.
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It’s a regulation meant to ensure that poor and rich communities alike have equal access to hospitals, hospices and other health facilities. But at $10,000 to $50,000 per facility, it’s also costly and can lead to lengthy lawsuits. And Republican state lawmakers want to repeal the regulation this year.
A Florida House subcommittee will vote Thursday afternoon on legislation (HB 7) repealing the program, called certificate of need. A similar proposal has been put forward in the Senate.
Republican Gov. Rick Scott, a former hospital executive, last month identified the repeal as one of his top priorities for the upcoming legislative session, which begins March 7.
"We’ve got an outdated certificate of need process," Scott said. "(Ending it) would help improve quality. It’d also control price and increase access."
Lawmakers have proposed ending the requirement, first passed in 1973, in previous years. Last year, the House passed a repeal but the Senate shot it down amid fears that increased competition could lead to each hospital performing fewer procedures.
"Volume, in terms of practice for physicians, makes for better quality," former Sen. Eleanor Sobel, D-Hollywood, said last year before voting down a more measured cutback to certificate of need. "I believe this upsets the cart."
Fleming Island Republican Sen. Rob Bradley, who is sponsoring a repeal in the Senate this year, said other licensing requirements would address quality concerns and that competition could drive down prices.
"There are some of these other proposals that are described as increasing access in health care that I fear have the potential of impacting quality if not properly implemented," Bradley said. "I look at the (certificate of need) issue and see that as improving access but not adversely affecting quality."
Politically, the Senate may be more likely to consider ending certificate of need this year because of a dramatic turnover in its membership: 20 senators are new to the chamber this year, and many of them made the shift from the House.
With a likely change to health care on the federal level as Republicans in Washington consider repealing and replacing the Affordable Care Act, Florida lawmakers say the state needs to start looking for creative ways to keep health care costs low.
More competition, some Republicans say, does just that.
"You have to be prepared for a new day in health care," Bradley said. "I think in Florida we can be a leader in free-market approaches to health care delivery. An important part of that is making sure that if a market can support competition, that we don’t have unnecessary regulations in place to prevent that competition."
Contact Michael Auslen at mauslen@tampabay.com. Follow @MichaelAuslen.
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