In November, Florida voters will be presented with one of the longest ballots in our state’s history. So large that ballots in certain counties will be increased from their normal size of 8.5 by 11inches to 8.5 by 18 inches. Despite the enlargement, voters will still be left with multiple, dual sided, pages to mull over. While there will be many political seats to consider, a central cause of the length is the eleven constitutional amendments which are up for a vote, many of which are lengthy in their full form, and all of which are sponsored by the State Legislature, rather than citizen initiated.
As in every election cycle, citizens are urged to make a decision on the proposed amendments before entering their voting precinct. The language used for constitutional amendments can be muddy and difficult to decipher while other eager voters wait their turn behind you. It is for these reasons we should get to know our amendments before November 6th. It is with that mission in mind that I present this amendment, its background, and my thoughts on its possible affect on our state and its residents.
Amendment One, Health Care Services
Proposing an amendment to the State Constitution to prohibit laws or rules from compelling any person or employer to purchase, obtain, or otherwise provide for health care coverage; permit a person or an employer to purchase lawful health care services directly from a health care provider; permit a health care provider to accept direct payment from a person or an employer for lawful health care services; exempt persons, employers, and health care providers from penalties and taxes for paying directly or accepting direct payment for lawful health care services; and prohibit laws or rules from abolishing the private market for health care coverage of any lawful health care service. Specifies that the amendment does not affect which health care services a health care provider is required to perform or provide; affect which health care services are permitted by law; prohibit care provided pursuant to general law relating to workers’ compensation; affect laws or rules in effect as of March 1, 2010; affect the terms or conditions of any health care system to the extent that those terms and conditions do not have the effect of punishing a person or an employer for paying directly for lawful health care services or a health care provider for accepting direct payment from a person or an employer for lawful health care services; or affect any general law passed by two-thirds vote of the membership of each house of the Legislature, passed after the effective date of the amendment, provided such law states with specificity the public necessity justifying the exceptions from the provisions of the amendment. The amendment expressly provides that it may not be construed to prohibit negotiated provisions in insurance contracts, network agreements, or other provider agreements contractually limiting copayments, coinsurance, deductibles, or other patient charges.
What it means:
This bill was introduced as a countermeasure to the Affordable Care Act (aka Obamacare) and has three aims, (1) Ensuring that individuals, businesses and healthcare providers are not required to participate in the healthcare system, (2) authorizing individuals and employers to pay for health care services directly and without fear of penalty, (3) and authorizing health care providers to accept direct payment, also without fines or penalty. The first item mentioned is to protect against the individual mandate required by the ACA. Items 2 and 3 are aimed at countering the state-based health insurance marketplaces that the ACA requires be set up in the near future.
The legislature introduced a similar amendment in 2010 titled Florida Health Care Freedom, which was scheduled to appear on the November gubernatorial ballot. However, on Aug. 30, it was stricken from the ballot by the Florida Supreme Court citing, “…the ballot language put forth by the party proposing the constitutional amendment contains misleading and ambiguous language.” The case goes on to note the specific terms and phrases that cause concern. On Nov. 30, 2010, Health Care Services, CS/SJR 2, was submitted as a replacement for consideration during the 2011 Legislative Session. It passed both chambers and is now Amendment 1 on our 2012 presidential ballot.
Following congressional approval of the Affordable Care Act in 2010, Republican sponsored legislation aimed at preventing healthcare reform began cropping up in many state’s chambers and on election ballots; and during that time I could understand states’ urgency for quick reprisal. However, we are two years in the future and the U.S. Supreme Court has ruled that the ACA is constitutional. Legislation like Amendment 1 seems redundant and unproductive. While states do have the constitutional right to the creation of their own legislation, the supremacy clause, cited in the U.S. Constitution, states that federal law, “…shall be the supreme Law of the Land”. Our state will not be able to act on this measure if it passes with the necessary 60%. Residents will be able to vote “yes” to Amendment 1 in protest but not with the expectation of action or, more appropriately in this case, inaction.
In a democracy, it is important to challenge the government but at what cost? This measure has demanded two years of our Legislature’s time and taxpayers’ money and accomplishes nothing legally but represents our ideological misgivings. Moreover, the presence of this law on our state’s constitution can be cause for constitutional review, which will further increase the cost of this bill both in the Legislature and the Judiciary. I worry that the longer we delay preparing for the changes brought about by the ACA, the less our state will be included in the process and which could mean the loss of possible benefits for Floridians. I suggest we encourage and assist our state government in making the new marketplace venues run smoothly and effectively for our own benefit; because whether we support the ACA or not, it will very soon affect our lives. Otherwise, the Department of Health & Human Services will establish a system which will lack an intimate knowledge of Florida and its residents’ needs. Our involvement is essential.