Florida Health Insurance Advisory Board Recommends Deductible Health Credit Transfers and Insulin Cost Caps to Legislature – State of Reform

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 FHIAB by Louisa McQueeney, Florida Voices for Health program director and FHIAB board member, at a meeting in September.

Some of the key policy recommendations approved by the board include allowing deductible health credit transfers between health plans, as well as state protection of 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 medications.

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

“With the continued increase in annual health insurance deductibles for consumers, having to start a new deductible mid-year creates financial hardship,” Florida Voices for Health said of the recommendation.

“When consumers change health insurance plans outside of the open enrollment period, due to a change of employer outside of the annual renewal, or a change of employer, or a change of geographic area, or the loss of employer coverage and the purchase of individual coverage, annual deductibles start all over again even if a consumer has encountered some or all of the accumulators out of their own pocket.

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

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

Another policy recommendation is that the state prohibit insurance companies from modifying or discontinuing a covered prescription drug during the policy year. Florida Voices for Health said the recommendation is largely a response to insurance companies that have made changes to their drug formularies during the coverage period in recent years.

“Insurers regularly reclassify drugs to [better] accessing restrictive drug levels, increasing the consumer’s co-payment, coinsurance or deductible, and reclassifying drugs to higher cost-sharing levels. There are also instances where certain medications are removed from coverage altogether. Consumers are then informed by letter that they will be financially responsible for the full cost of the drug at the midpoint of the insurance year.

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

Florida Voices for Health pointed out that this cost cap would significantly reduce the cost of health care for Floridians.

“The recently enacted Cut Inflation Act will reduce the cost of insulin to a maximum of $35 per month for people on Medicare starting in 2023. This includes insulin pumps. However, the new law does not extend to individual and group health plans The cost of insulin, which has been around for 100 years, is 10 times higher in the United States than in any other developed country and creates an enormous financial burden for Floridians who cannot survive without.