Health care’s big year

Kimberly Leonard's must-read briefing on what's hot, crazy or shady about politics in the Sunshine State

Nov 14, 2023 View in browser   By Kimberly Leonard Lawmakers are considering major changes to a host of health-related issues. | Win McNamee/Getty Images Good morning and welcome to Tuesday. The upcoming Legislative session is shaping up to be the year of health care. The state Senate is considering sweeping changes on everything from the affordability of medical school to addressing workforce shortages and using video to meet with patients. Senate President Kathleen Passidomo (R-Naples) is making health care a top focus of the session — and she’s enlisting lawmakers in the Committee on Health Policy to start outlining the package during a workshop this afternoon. Florida leaves plenty wanting when it comes to health care, with 2.6 million uninsured and ranking almost last among states in getting people the mental health treatment they need. More than one in five Floridians are also seniors, who tend to face more serious long-term health challenges and need care related to chronic illnesses such as cancer, heart disease and dementia. Among measures senators are looking at are ways to keep patients out of the emergency room, making it easier for Floridians to get health care screenings, getting smaller practices to install technology for video visits and replenishing a fund that helps pay for medical education, said state Sen. Colleen Burton (R-Lakeland), who chairs the Health Policy Committee. In her nine years in the Legislature, she said, she had never approached a topic “in such a comprehensive manner where we tackle so many issues at one time in a bill.” The problems the state faces have been bubbling up. After Covid, the Legislature passed numerous bills geared toward shielding Floridians from vaccine and mask mandates. But with the pandemic also came a surge of residents to Florida, and Passidomo said in a memo sent last week that given the growing population, Florida was projected to have an 18,000-person doctor shortfall by 2035. A driving topic in the two-hour meeting today will be worker shortages, an issue that has plagued Florida for years. Jen Lawrence, chief nursing officer at Aston Health and presenter for the Florida Health Care Association, will talk about how hard it is to recruit workers for nursing homes, which compete with higher-paying hospitals. She’ll also share how some facilities address the problem by offering training for nursing certifications at work sites, said Kristen Knapp, the association’s spokesperson. Expect ramped-up lobbying on this ahead of the 2024 session that starts Jan. 9 with lots of requests — and questions — coming from numerous corners of the health care sector. Looking at mental health, for instance, organizations like the Florida Council for Behavioral Healthcare say loan forgiveness will be key to growing the workforce, and want to make sure in all cases that health care workers will get paid the same for seeing a patient over telehealth as they would for an in-person visit, said the group’s president, Melanie Brown Woofter. Florida House members also are compiling ideas — there was a Select Committee on Health Innovation hearing yesterday — and bills in the Senate will get introduced before the end of the year, Burton said. — WHERE'S RON? Gov. DeSantis will join Wake Up Carolina with Ken Ard on WFRK Live 95.3 in Florence, S.C. at 8:20 a.m. ET. He’ll also join Doug Wagner on AM 600 WMT in Cedar Rapids, Iowa at 8:40 a.m. ET. He’s also meeting with government officials and trade partners in Jacksonville, Fla. Have a tip, story, suggestion, birthday, anniversary, new job, or any other nugget for Playbook? Get in touch at: kleonard@politico.com   GO INSIDE THE CAPITOL DOME: From the outset, POLITICO has been your eyes and ears on Capitol Hill, providing the most thorough Congress coverage — from political characters and emerging leaders to leadership squabbles and policy nuggets during committee markups and hearings. We're stepping up our game to ensure you’re fully informed on every key detail inside the Capitol Dome, all day, every day. Start your day with Playbook AM, refuel at midday with our Playbook PM halftime report and enrich your evening discussions with Huddle. Plus, stay updated with real-time buzz all day through our brand new Inside Congress Live feature. Learn more and subscribe here.     ... DATELINE TALLAHASSEE ... TODAY — Several state House and Senate committees are meeting on commerce, appropriations and agriculture. (Tune in.) SIGNED INTO LAW — DeSantis on Monday authorized measures the Legislature sent him during the special session, including on funding for home hardening, disaster relief, vouchers for students with disabilities and security for Jewish day schools. UNINSURED — “Thousands of Florida children appear to not have coverage in Medicaid unwinding,” reports WMFE’s Joe Mario Pedersen. “Nearly a quarter of a million children were ineligible for Medicaid as the state is about halfway through its redetermination process, in which the Department of Children and Family Services is reevaluating eligibility for 5.5 million Floridians. So far, DCF has disenrolled around 260,000 children from Medicaid across the state. The state plan was to have those qualifying children enter Florida’s kid healthcare plan. Only 25,000 have enrolled.” ABORTION AMENDMENT — “Abortion-rights supporters push court to OK wording on proposed constitutional amendment,” reports New Service of Florida’s Jim Saunders. “Attorneys for Floridians Protecting Freedom wrote Friday that the meaning of the word ‘viability’ in the context of abortion has long been understood and that voters ‘can be trusted to know what it would mean to live in a world limiting government interference with abortion before viability.’” NOT ENFORCED — “In a highly unusual move, two of Florida’s biggest universities are pushing back against the DeSantis administration over its orders to shut down pro-Palestinian student organizations on campus, citing lawyers’ advice warning that administrators could face personal legal liability if they followed what might be an unconstitutional directive,” reports WUFT’s Claire Grunewald. ‘WOKE’ FATIGUE — “Black Floridians grow increasingly frustrated over DeSantis' moves as election year looms,” reports Florida Today’s J.D. Gallop. Many Black Floridians “across the political spectrum say that hope has been replaced by a tired, familiar sense of exhaustion at what seems to be a slide backwards, particularly in Florida where the war on ‘woke culture,’ Black history and diversity programs is hard to escape.” BRIEF FILED — ”Biden backs ruling to keep ill children out of Florida nursing homes,” reports News Service of Florida’s Jim Saunders. “With a hearing slated in January, the Biden administration is urging a federal appeals court to uphold a ruling aimed at keeping Florida children with complex medical conditions out of nursing homes, saying it would ensure they are ‘granted equality and freedom from unwarranted isolation.’” EXPIRATION DATE — “Blaise Ingoglia, Michelle Salzman seek term limits for county commissioners,” reports Florida Politics’ Jacob Ogles. The limit would be eight consecutive years. — “Ambitious Florida CFO Patronis and the case of the curious $50,000 political contribution,” by Florida Bulldog’s Dan Christensen — “Fabian Basabe will not be canceled,” by New York Magazine’s Ben Widdicombe — Gas prices in Florida are likely to stay low through Thanksgiving, reports the South Florida Sun Sentinel’s Abigail Hasebroock PENINSULA AND BEYOND Marijuana plants. | Jim Mone, File/AP CANNABIS ECONOMY — Trulieve CEO Kim Rivers on Monday said Florida’s $2 billion medical marijuana industry would grow by three times if voters were to legalize pot for recreational use next year — and she hopes other companies will start chipping in. Trulieve was the sole contributor of more than $39 million toward a ballot initiative seeking to legalize pot by expanding the state’s medical marijuana industry. Most of the money went toward gathering the more than 891,000 certified voter signatures required by the state to qualify. The initiative is now in the hands of the state Supreme Court, which appeared favorable during oral arguments last week. Rivers said if the Supreme Court gives the green light, she hopes that the campaign will see more financial support from the 23 other companies licensed by the state to sell medical pot. “I’m hopeful that it will be a collective effort,” Rivers said after giving reporters a tour of Trulieve’s new 750,000-square foot grow facility east of Tallahassee. “And I think that is the conversation we’ve had with other companies in the state of Florida.” The initiative would need at least 60 percent of the vote to pass, and Rivers said that kind of result would amplify the push to loosen controls on marijuana in Washington. The DEA is currently reviewing a Health and Human Services recommendation to remove pot’s illicit status as a drug similar to heroin. A measure that would loosen pot restrictions tied to the banking industry is also under consideration by the Senate. “It will be meaningful. I'll say that, moving from approximately a $2 billion industry to a $6 billion industry,” Rivers said. “You're talking about three times from a growth perspective.” — Arek Sarkissian CAMPAIGN MODE MOVING OUT — DeSantis dispatches three top aides to Iowa, reports POLITICO’s Alex Isenstadt. Deputy campaign manager David Polyansky, national political director Sam Cooper and communications director Andrew Romeo are among the DeSantis aides who will now work from Iowa through the caucus, according to a person familiar with the plan. In all, the campaign is sending roughly 20 people — or one-third — of its Tallahassee-based national staff to the state. Additional aides could be deployed to Iowa in December. COMPLAINT — “Senate GOP campaign arm hits Sen. Rick Scott primary opponent with finance complaint,” reports NBC News’ Matt Dixon. “The Senate Republicans' official campaign arm in Washington is filing a complaint alleging that the Republican challenging Scott in 2024 used businesses he owns to make impermissible contributions to his campaign. The complaint from the National Republican Senatorial Committee is hitting Keith Gross, a Panama City, Florida, businessman and attorney who has said he would spend millions of dollars from his personal wealth to try and defeat Scott, a first-term senator and former two-term Florida governor.” TRANSITION TIME The free expression organization PEN America hired attorney Katie Blankenship as its first-ever Florida director. Blankenship previously was deputy legal director for the ACLU of Florida. “She will lead an accelerated effort amid the crisis of censorship in Florida public schools and efforts to undermine academic freedom, and diversity and inclusion on college campuses,” the group said in a statement. ODDS, ENDS AND FLORIDA MEN GIVEAWAY — “Pop singer Pink will give away 2,000 banned books at Miami area concerts this week,” per CNN’s Nicole Chavez BIRTHDAYS: Former Florida House Speaker Will Weatherford   GET A BACKSTAGE PASS TO COP28 WITH GLOBAL PLAYBOOK: Get insider access to the conference that sets the tone of the global climate agenda with POLITICO's Global Playbook newsletter. Authored by Suzanne Lynch, Global Playbook delivers exclusive, daily insights and comprehensive coverage that will keep you informed about the most crucial climate summit of the year. Dive deep into the critical discussions and developments at COP28 from Nov. 30 to Dec. 12.. 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