Florida Senate - 2025 SB 1670
By Senator Smith
17-00435A-25 20251670__
1 A bill to be entitled
2 An act relating to statewide health care coverage;
3 defining terms; establishing the Task Force on
4 Universal Health Care for Florida for a specified
5 purpose; requiring the Office of Program Policy
6 Analysis and Government Accountability (OPPAGA) to
7 provide staff support to the task force; directing all
8 agencies of state government to assist the task force,
9 including furnishing information and advice deemed
10 necessary by the task force; providing for the
11 membership, meetings, and funding of the task force;
12 requiring the task force to establish an advisory
13 committee for a specified purpose; providing for the
14 membership of the advisory committee; authorizing the
15 task force to establish additional advisory and
16 technical committees; specifying duties of the task
17 force; requiring the task force to consider specified
18 values and principles in developing certain
19 recommendations; requiring the task force to make
20 findings and recommendations for the design of the
21 Health Care for All Florida Plan and for the Health
22 Care for All Florida Board to administer the plan;
23 specifying requirements for the design of the plan;
24 specifying requirements for the plan and factors the
25 task force must include in its recommendations;
26 requiring the task force to engage in a public process
27 to solicit public input on certain elements of the
28 plan; specifying requirements for such process;
29 specifying requirements for the report of the task
30 force’s findings and recommendations; requiring that
31 task force members be appointed by a specified date;
32 requiring OPPAGA to begin preparing a work plan for
33 the task force by a specified date; requiring the task
34 force to submit a report of its findings and
35 recommendations to the Governor and the Legislature by
36 a specified date; requiring the Agency for Health Care
37 Administration to develop a plan for a Medicaid buy-in
38 program or a public health care option for certain
39 residents of this state; specifying requirements for
40 the plan; requiring the agency to report its plan to
41 the Governor and the Legislature by a specified date;
42 providing for the future repeal of specified
43 provisions; providing an appropriation; providing an
44 effective date.
45
46 Be It Enacted by the Legislature of the State of Florida:
47
48 Section 1. Task Force on Universal Health Care for
49 Florida.—
50 (1) DEFINITIONS.—As used in this section, the term:
51 (a) “Group practice” means a single legal entity composed
52 of individual providers organized as a partnership, professional
53 corporation, limited liability company, foundation, nonprofit
54 corporation, or faculty practice plan or a similar association
55 in which:
56 1. Each individual provider uses office space, facilities,
57 equipment, and personnel shared with other individual providers
58 to deliver medical care, consultation, diagnosis, treatment, or
59 other services that the provider routinely delivers in the
60 provider’s practice;
61 2. Substantially all of the services delivered by the
62 individual providers are delivered on behalf of the group
63 practice and billed as services provided by the group practice;
64 3. Substantially all of the payments to the group practice
65 are to reimburse the cost of services provided by the individual
66 providers in the group practice;
67 4. The overhead expenses of, and the income from, the group
68 practice are shared among the individual providers in the group
69 practice in accordance with methods agreed to by the individual
70 providers who are members of the group practice; and
71 5. There is a unified business model with consolidated
72 billing, accounting, and financial reporting and a centralized
73 decisionmaking body that represents the individual providers who
74 are members of the group practice.
75 (b) “Individual provider” means a health care practitioner
76 who is licensed, certified, or registered in this state or who
77 is licensed, certified, or registered to provide care in another
78 state or country.
79 (c) “Institutional provider” means a single legal entity
80 that is:
81 1. A health care facility, such as a hospital;
82 2. A comprehensive outpatient rehabilitation facility;
83 3. A home health agency; or
84 4. A hospice program.
85 (d) “Provider” means an individual provider, an
86 institutional provider, or a group practice.
87 (e) “Single-payor health care financing system” means a
88 universal system used by the state for paying the cost of health
89 care services or goods in which:
90 1. Institutional providers are paid directly for health
91 care services or goods by the state or are paid by an
92 administrator that does not bear risk in its contracts with the
93 state;
94 2. Group practices are paid directly for health care
95 services or goods by the state or are paid by an administrator
96 that does not bear risk in its contracts with the state, by the
97 employer of the group practice, or by an institutional provider;
98 and
99 3. Individual providers are paid directly for health care
100 services or goods by the state, by their employers, by an
101 administrator that does not bear risk in its contracts with the
102 state, by an institutional provider, or by a group practice.
103 (2) ESTABLISHMENT OF THE TASK FORCE ON UNIVERSAL HEALTH
104 CARE; PURPOSE; AGENCY COOPERATION.—The Task Force on Universal
105 Health Care is established to recommend the design of the Health
106 Care for All Florida Plan, a universal health care system
107 administered by the Health Care for All Florida Board which is
108 equitable, affordable, and comprehensive; provides high-quality
109 health care; and is publicly funded and available to every
110 individual residing in this state. The Office of Program Policy
111 Analysis and Government Accountability (OPPAGA) shall provide
112 staff support to the task force. All agencies of state
113 government are directed to assist the task force in the
114 performance of its duties and, to the extent permitted by laws
115 relating to confidentiality, to furnish information and advice
116 deemed necessary by the task force to perform its duties.
117 (3) MEMBERSHIP; MEETINGS; FUNDING; ADVISORY COMMITTEES.—
118 (a) The task force shall be composed of the following 20
119 members:
120 1. Two members of the Senate, one from the majority party
121 and one from the minority party, appointed by the President of
122 the Senate.
123 2. Two members of the House of Representatives, one from
124 the majority party and one from the minority party, appointed by
125 the Speaker of the House of Representatives.
126 3. Thirteen members appointed by the Governor, each of whom
127 must reside in this state and:
128 a. Represent to the greatest extent practicable:
129 (I) Diverse social identities, including, but not limited
130 to, individuals who identify by geography, race, ethnicity, sex,
131 gender nonconformance, sexual orientation, economic status,
132 disability, or health status; and
133 (II) Diverse areas of expertise, based on knowledge and
134 experience, including, but not limited to, patient advocacy,
135 receipt of medical assistance, management of a business that
136 offers health insurance to its employees, public health,
137 organized labor, provision of health care, or owning a small
138 business;
139 b. Represent, at a minimum, the following areas of
140 expertise acquired by education, vocation, or personal
141 experience:
142 (I) Rural health;
143 (II) Quality assurance and health care accountability;
144 (III) Fiscal management and change management;
145 (IV) Social services;
146 (V) Public health services;
147 (VI) Medical and surgical services;
148 (VII) Alternative therapy services;
149 (VIII) Services for persons with disabilities; and
150 (IX) Nursing services;
151 c. Include at least eight members who are representatives
152 of labor unions representing employees who work in the health
153 care field in this state;
154 d. Include at least one member who is a representative of a
155 Florida legal aid organization helping health care patients;
156 e. Include at least one member who has produced at least
157 three economic analyses of the economic benefits of single-payor
158 programs on the state level. This member need not be a resident
159 of this state in order to serve on the task force; and
160 f. Include at least one member who has an active license to
161 practice social work in this state.
162 4. The State Surgeon General or his or her designee, who is
163 a nonvoting member.
164 5. The Secretary of Business and Professional Regulation or
165 his or her designee, who is a nonvoting member.
166 6. A member of the Florida Association of Counties,
167 selected by the association, who is a nonvoting member.
168 (b) In making the appointments under subparagraph (a)3.,
169 the Governor shall ensure that there is no disproportionate
170 influence by any individual, organization, government, industry,
171 business, or profession in any decisionmaking by the task force
172 and no actual or potential conflicts of interest.
173 (c) The task force shall elect one of its members to serve
174 as chair and one to serve as vice chair.
175 (d) If there is a vacancy for any cause, the appointing
176 authority must make an appointment to fill the vacancy, which
177 appointment becomes effective immediately.
178 (e) Members of the Legislature appointed to the task force
179 are nonvoting members of the task force and may act in an
180 advisory capacity only.
181 (f) A majority of the voting members of the task force
182 constitutes a quorum for the transaction of business.
183 (g) Official action by the task force requires the approval
184 of a majority of the voting members of the task force.
185 (h) The task force shall meet at times and places specified
186 by the call of the chair or by a majority of the voting members
187 of the task force.
188 (i) Members of the task force are not entitled to
189 compensation but are entitled to receive per diem and travel
190 expenses as provided in s. 112.061, Florida Statutes.
191 (j) The task force may apply for public or private grants
192 from nonprofit organizations for the costs of research.
193 (k)1. The task force shall establish an advisory committee
194 to provide input from a consumer perspective and, to the
195 greatest extent practicable, from the diverse social identities
196 described in sub-sub-subparagraph (a)3.a.(I).
197 2. Members of the advisory committee must have the
198 following qualifications, such that at least one member:
199 a. Has experience in seeking or receiving health care in
200 this state to address one or more serious medical conditions or
201 disabilities.
202 b. Is enrolled in health insurance offered by the state
203 group insurance program or represents public employees.
204 c. Is enrolled in employer-sponsored health insurance,
205 group health insurance, or a self-insured health plan offered by
206 an employer.
207 d. Is enrolled in commercial insurance purchased without
208 any employer contribution.
209 e. Receives medical assistance.
210 f. Is enrolled in Medicare.
211 g. Is a parent or guardian of a child enrolled in the
212 Children’s Health Insurance Program.
213 h. Is enrolled in the Federal Employees Health Benefits
214 Program.
215 i. Is enrolled in TRICARE.
216 j. Receives care from the United States Department of
217 Veterans Affairs Veterans Health Administration.
218 k. Receives care from the Indian Health Service.
219 (l) The task force may establish additional advisory or
220 technical committees that the task force considers necessary.
221 The committees may be continuing or temporary. The task force
222 shall determine the representation, membership, terms, and
223 organization of the committees and shall appoint the members of
224 the committees.
225 (m) Members of advisory or technical committees are not
226 entitled to compensation but may, in the discretion of the task
227 force, be reimbursed for per diem and travel expenses as
228 provided in s. 112.061, Florida Statutes.
229 (4) DUTIES; VALUES; PRINCIPLES.—
230 (a) The task force shall produce findings and
231 recommendations for a well-functioning, single-payor health care
232 financing system that is responsive to the needs and
233 expectations of the residents of this state by:
234 1. Improving the health status of individuals, families,
235 and communities;
236 2. Defending against threats to the health of the residents
237 of this state;
238 3. Protecting individuals from the financial consequences
239 of ill health;
240 4. Providing equitable access to person-centered care;
241 5. Removing cost as a barrier to accessing health care;
242 6. Removing any financial incentive for a health care
243 practitioner to provide care to one patient over another;
244 7. Making it possible for individuals to participate in
245 decisions affecting their health and the health care system;
246 8. Establishing measurable health care goals and guidelines
247 that align with other state and federal health standards; and
248 9. Promoting continuous quality improvement and fostering
249 interorganizational collaboration.
250 (b) The task force, in developing its recommendations for
251 the Health Care for All Florida Plan, shall consider, at a
252 minimum, all of the following values:
253 1. Health care, as a fundamental element of a just society,
254 is to be secured for all individuals on an equitable basis by
255 public means, similar to public education, public safety, and
256 other public infrastructure.
257 2. Access to a distribution of health care resources and
258 services should be available according to each individual’s
259 needs and location within this state. Race, color, national
260 origin, age, disability, wealth, income, citizenship status,
261 primary language use, genetic conditions, previous or existing
262 medical conditions, religion, or sex, including sex
263 stereotyping, gender identity, sexual orientation, and pregnancy
264 and related medical conditions, such as termination of
265 pregnancy, may not create any barriers to health care or
266 disparities in health outcomes due to access to care.
267 3. The components of the system must be accountable and
268 fully transparent to the public with regard to information,
269 decisionmaking, and management through meaningful public
270 participation in decisions affecting people’s health care.
271 4. Funding for the Health Care for All Florida Plan is a
272 public trust, and any savings or excess revenue is to be
273 returned to that public trust.
274 (c) The task force, in developing its recommendations for
275 the Health Care for All Florida Plan, shall consider, at a
276 minimum, all of the following principles:
277 1. A participant in the plan may choose any individual
278 provider who is licensed, certified, or registered in this state
279 or any group practice.
280 2. The plan may not discriminate against any individual
281 provider who is licensed, certified, or registered in this state
282 to provide services covered by the plan and who is acting within
283 the provider’s scope of practice.
284 3. A participant and the participant’s provider shall,
285 within the scope of services covered within each category of
286 care and within the plan’s parameters for standards of care and
287 requirements for prior authorization, determine whether a
288 treatment is medically necessary or medically appropriate for
289 that participant.
290 4. The plan must cover services from birth to death, based
291 on evidence-based decisions as determined by the Health Care for
292 All Florida Board.
293 (5) SCOPE OF DESIGN FOR THE HEALTH CARE FOR ALL FLORIDA
294 PLAN.—
295 (a) The task force shall make findings and recommendations
296 for the design of the Health Care for All Florida Plan and the
297 Health Care for All Florida Board, which shall administer the
298 plan. The task force shall submit a report of its findings and
299 recommendations to the Governor, the President of the Senate,
300 and the Speaker of the House of Representatives as specified in
301 subsection (6). The task force’s recommendations must be
302 succinct statements and include actions and timelines, the
303 degree of consensus among the task force members, and the
304 priority of each recommendation, based on urgency and
305 importance. The task force may defer any recommendations to be
306 determined by the board.
307 (b) The design of the Health Care for All Florida Plan
308 recommended by the task force must:
309 1. Adhere to the values and principles described in
310 paragraphs (4)(b) and (c);
311 2. Be a single-payor health care financing system;
312 3. Ensure that individuals who receive services from the
313 United States Department of Veterans Affairs Veterans Health
314 Administration or the Indian Health Services may be enrolled in
315 the plan while continuing to receive those services;
316 4. Obtain a waiver of federal requirements that pose
317 barriers to, or adopt other approaches, enabling equitable and
318 uniform inclusion of all residents such that a resident of this
319 state who has other coverage that is not subject to state
320 regulation may enroll in the plan without jeopardizing
321 eligibility for the other coverage if the person moves out of
322 this state; and
323 5. Preserve the coverage of the health services currently
324 required by Medicare, Medicaid, the Children’s Health Insurance
325 Program, the Patient Protection and Affordable Care Act, Pub. L.
326 No. 111-148, as amended by the Health Care and Education
327 Reconciliation Act of 2010, Pub. L. No. 111-152, Florida’s
328 medical assistance program for the needy, and any other state or
329 federal program.
330 (c) The plan must allow participation by any individual
331 who:
332 1. Resides in this state;
333 2. Is a nonresident who works full time in this state and
334 contributes to the plan; or
335 3. Is a nonresident who is a dependent of an individual
336 described in subparagraph 1. or subparagraph 2.
337
338 The task force’s recommendations must address issues related to
339 the provision of services to nonresidents who receive services
340 in this state and to plan participants who receive services
341 outside of this state.
342 (d) Providers shall be paid under the plan as follows or
343 through an alternative method that is similarly equitable and
344 cost-effective:
345 1. Individual providers licensed in this state shall be
346 paid:
347 a. On a fee-for-services basis;
348 b. As employees of institutional providers or members of
349 group practices that are reimbursed with global budgets; or
350 c. As individual providers in group practices that receive
351 capitation payments for providing outpatient services as
352 permitted by subparagraph 4.
353 2. Institutional providers shall be paid with global
354 budgets that include separate capital budgets, determined
355 through regional planning, and operational budgets.
356 3. Budgets must be determined for individual hospitals and
357 not for entities that own multiple hospitals, clinics, or other
358 providers of health care services or goods.
359 4. A group practice may be reimbursed with capitation
360 payments if the group practice:
361 a. Primarily uses individual providers in the group
362 practice to deliver care in the group practice’s facilities;
363 b. Does not use capitation payments to reimburse the cost
364 of hospital services; and
365 c. Does not offer financial incentives to individual
366 providers in the group practice based on the use of services.
367 (e) In designing the plan, the task force shall:
368 1. Develop cost estimates for the plan, including, but not
369 limited to, cost estimates for:
370 a. The approach recommended for achieving the result
371 described in subparagraph (b)4.; and
372 b. The payment method designed by the task force under
373 paragraph (d) in designing the plan;
374 2. Consider how the plan will impact the structure of
375 existing state and local boards and commissions, counties,
376 cities, and special districts, as well as the Federal
377 Government, other states, and Indian tribes;
378 3. Investigate other states’ attempts at providing
379 universal coverage and using single-payor health care financing
380 systems, including the outcomes of those attempts; and
381 4. Consider the work by existing health care professional
382 boards and commissions and incorporate important aspects of such
383 work into recommendations for the plan.
384 (f) In developing recommendations for long-term care
385 services and supports for the plan under subparagraph (i)16.,
386 the task force shall convene an advisory committee that
387 includes:
388 1. Persons with disabilities who receive long-term services
389 and supports;
390 2. Older adults who receive long-term services and
391 supports;
392 3. Individuals representing persons with disabilities and
393 older adults;
394 4. Members of groups that represent the diversity,
395 including by gender, race, and economic status, of individuals
396 who have disabilities;
397 5. Providers of long-term services and supports, including
398 in-home care providers who are represented by organized labor,
399 and family attendants and caregivers who provide long-term
400 services and supports; and
401 6. Academics and researchers in relevant fields of study.
402
403 Notwithstanding subparagraph (i)16., the task force may explore
404 the effects of excluding long-term care services from the plan,
405 including, but not limited to, the social, financial, and
406 administrative costs.
407 (g) The task force’s recommendations for the duties of the
408 board and the details of the plan must ensure that, by
409 considering the following factors, patients are empowered to
410 protect their health, their rights, and their privacy:
411 1. The patient’s access to patient advocates who are
412 responsible to the patient and maintain patient confidentiality
413 and whose responsibilities include, but are not limited to,
414 addressing concerns about providers and helping patients
415 navigate the process of obtaining medical care;
416 2. The patient’s access to culturally and linguistically
417 appropriate care and service;
418 3. The patient’s ability to obtain needed care when a
419 treating provider is unable or unwilling to provide the care;
420 4. Paying providers to complete forms or perform other
421 administrative functions to assist patients in qualifying for
422 disability benefits, family medical leave, or other income
423 supports; and
424 5. The patient’s access to and control of medical records,
425 including:
426 a. Empowering patients to control access to their medical
427 records and obtain independent second opinions, unless there are
428 clear medical reasons not to do so;
429 b. Requiring that a patient or the patient’s designee be
430 provided a complete copy of the patient’s health records
431 promptly after every interaction or visit with a provider;
432 c. Ensuring that the copy of the health records provided to
433 a patient includes all data used in the care of that patient;
434 and
435 d. Requiring that the patient or the patient’s designee
436 provide approval before any forwarding of the patient’s data to,
437 or access of the patient’s data by, family members, caregivers,
438 or other providers or researchers.
439 (h) In developing recommendations for the plan, the task
440 force shall engage in a public process to solicit public input
441 on the elements of the plan described in paragraphs (b), (i),
442 (j), and (k). The public process must:
443 1. Ensure input from individuals in rural and underserved
444 communities and from individuals in communities that experience
445 health care disparities;
446 2. Solicit public comments statewide while providing to the
447 public evidence-based information developed by the task force
448 about the health care costs of a single-payor health care
449 financing system, including the cost estimates developed under
450 paragraph (e), as compared to the current system; and
451 3. Solicit the perspectives of:
452 a. Individuals throughout the range of communities that
453 experience health care disparities;
454 b. A range of businesses, based on industry and employer
455 size;
456 c. Individuals whose insurance coverage represents a range
457 of current insurance types and individuals who are uninsured or
458 underinsured; and
459 d. Individuals with a range of health care needs, including
460 individuals needing disability services and long-term care
461 services who have experienced the financial and social effects
462 of policies requiring them to exhaust a large portion of their
463 resources before qualifying for long-term care services paid for
464 by the medical assistance program for the needy.
465 (i) With respect to administration of the plan, the report
466 must include, but need not be limited to, all of the following:
467 1. The governance and leadership of the board,
468 specifically:
469 a. The composition and representation of the membership of
470 the board, appointed or otherwise selected using an open and
471 equitable selection process;
472 b. The statutory authority the board will need to establish
473 policies, guidelines, mandates, incentives, and enforcement
474 needed to develop a highly effective and responsive single-payor
475 health care financing system;
476 c. The ethical standards and their enforcement for members
477 of the board such that there are the most rigorous protections
478 and prohibitions from actual or perceived economic conflicts of
479 interest; and
480 d. The steps for ensuring that there is no disproportionate
481 influence by any individual, organization, government, industry,
482 business, or profession in any decisionmaking by the board;
483 2. A list of federal and state laws and rules, state
484 contracts or agreements, and court actions or decisions that may
485 facilitate, constrain, or prevent implementation of the plan and
486 an explanation of how they may facilitate or constrain or
487 prevent implementation;
488 3. The plan’s economic sustainability, operational
489 efficiency, and cost control measures that include, but are not
490 limited to, the following:
491 a. A financial governance system supported by relevant
492 legislation, financial audit, and public expenditure reviews and
493 clear operational rules to ensure efficient use of public funds;
494 and
495 b. Cost control features, such as multistate purchasing;
496 4. Features of the plan that are necessary to continue to
497 receive federal funding that is currently available to the state
498 and estimates of the amount of the federal funding that will be
499 available;
500 5. Fiduciary requirements for the revenue generated to fund
501 the plan, including, but not limited to, the following:
502 a. A dedicated fund, separate and distinct from the General
503 Revenue Fund, which is held in trust for the residents of this
504 state;
505 b. Restrictions to be authorized by the board on the use of
506 the trust fund;
507 c. A process for creating a reserve fund by retaining
508 moneys in the trust fund if, over the course of a year, revenue
509 exceeds costs; and
510 d. Required accounting methods that eliminate the potential
511 for misuse of public funds, detect inaccuracies in provider
512 reimbursement, and use the most rigorous, generally accepted
513 accounting principles, including annual external audits and
514 audits at the time of each transition in the board’s executive
515 management;
516 6. Requirements for the purchase of reinsurance;
517 7. Bonding authority that may be necessary;
518 8. The board’s role in workforce recruitment, retention,
519 and development;
520 9. A process for the board to develop statewide goals,
521 objectives, and ongoing review;
522 10. The appropriate relationship between the board and
523 regional or local authorities regarding oversight of health
524 activities, health care systems, and providers to promote
525 community health reinvestment, equity, and accountability;
526 11. Criteria to guide the board in determining which health
527 care services are necessary for the maintenance of health, the
528 prevention of health problems, the treatment or rehabilitation
529 of health conditions, and the provision of long-term and respite
530 care. Criteria may include, but are not limited to, the
531 following:
532 a. Whether the services are cost-effective and based on
533 evidence from multiple sources;
534 b. Whether the services are currently covered by the health
535 benefit plans offered by the state group insurance program;
536 c. Whether the services are designated as effective by the
537 United States Preventive Services Task Force, the United States
538 Centers for Disease Control and Prevention’s Advisory Committee
539 on Immunization Practices, the federal Health Resources and
540 Services Administration’s Bright Futures Program, or the
541 National Academies Institute of Medicine’s Committee on
542 Preventive Services for Women; and
543 d. Whether the evidence on the effectiveness of services
544 comes from peer-reviewed medical literature, existing
545 assessments and recommendations from state and federal boards
546 and commissions, and other peer-reviewed sources;
547 12. A process to track and resolve complaints, grievances,
548 and appeals, including establishing an Office of the Patient
549 Advocate;
550 13. Options for transition planning, including an impact
551 analysis on existing health care systems, providers, and patient
552 relationships;
553 14. Options for incorporating cost containment measures,
554 such as prior approval and prior authorization requirements, and
555 the effect of such measures on equitable access to quality
556 diagnosis and care;
557 15. The methods for reimbursing providers for the cost of
558 care as described in paragraph (d) and recommendations regarding
559 the appropriate reimbursement for the cost of services provided
560 to plan participants when they are traveling outside this state;
561 and
562 16. Recommendations for long-term care services and
563 supports that are tailored to each individual’s needs based on
564 an assessment. The services and supports may include, but need
565 not be limited to:
566 a. Long-term nursing services provided by an institutional
567 provider or in a community-based setting;
568 b. A broad spectrum of long-term services and supports,
569 including home and community-based settings or other
570 noninstitutional settings;
571 c. Services that meet the physical, mental, and social
572 needs of individuals while allowing them maximum possible
573 autonomy and maximum civic, social, and economic participation;
574 d. Long-term services and supports that are not based on
575 the individual’s type of disability, level of disability,
576 service needs, or age;
577 e. Services provided in the least restrictive setting
578 appropriate to the individual’s needs;
579 f. Services provided in a manner that allows persons with
580 disabilities to maintain their independence, self-determination,
581 and dignity;
582 g. Services and supports that are of equal quality and
583 accessibility in every geographic region of this state; and
584 h. Services and supports that give the individual the
585 opportunity to direct the services.
586 (j) The task force’s report must include:
587 1. The waivers of federal laws or other federal approval
588 that will be necessary to enable a person who is a resident of
589 this state and who has other coverage that is not subject to
590 state regulation to enroll in the plan without jeopardizing
591 eligibility for the other coverage if the person moves out of
592 this state;
593 2. Estimates of the savings and expenditure increases under
594 the plan, relative to the current health care system, including,
595 but not limited to:
596 a. Savings from eliminating waste in the current system and
597 from administrative simplification, fraud reduction, monopsony
598 power, simplification of electronic documentation, and other
599 factors that the task force identifies;
600 b. Savings from eliminating the cost of insurance that
601 currently provides medical benefits that would be provided
602 through the plan; and
603 c. Increased costs due to providing better health care to
604 more individuals than under the current health care system;
605 3. Estimates of the expected health care expenditures under
606 the plan, compared to the current health care system, reported
607 in categories similar to the National Health Expenditure
608 Accounts compiled by the Centers for Medicare and Medicaid
609 Services, including, but not limited to:
610 a. Personal health care expenditures;
611 b. Health consumption expenditures; and
612 c. State health expenditures;
613 4. Estimates of how much of the expenditures on the plan
614 will be made from moneys currently spent on health care in this
615 state from both state and federal sources and redirected or
616 used, in an equitable and comprehensive manner, to the plan;
617 5. Estimates of the amount, if any, of additional state
618 revenue that will be required;
619 6. Results of the task force’s evaluation of the impact on
620 individuals, communities, and the state if the current level of
621 health care spending continues without implementing the plan,
622 using existing reports and analysis where available; and
623 7. A description of how the Health Care for All Florida
624 Board or another entity may enhance:
625 a. Access to comprehensive, high-quality, patient-centered,
626 patient-empowered, equitable, and publicly funded health care
627 for all individuals;
628 b. Financially sustainable and cost-effective health care
629 for the benefit of businesses, families, individuals, and state
630 and local governments;
631 c. Regional and community-based systems integrated with
632 community programs to contribute to the health of individuals
633 and communities;
634 d. Regional planning for cost-effective, reasonable capital
635 expenditures that promote regional equity;
636 e. Funding for the modernization of public health, as an
637 integral component of cost efficiency in an integrated health
638 care system; and
639 f. An ongoing and deepening collaboration with Indian
640 tribes and other organizations providing health care which will
641 not be under the authority of the board.
642 (k)1. The task force’s findings and recommendations
643 regarding revenue for the plan, including redirecting existing
644 health care moneys under subparagraph (j)4., must be ranked
645 according to explicit criteria, including the degree to which an
646 individual, class of individuals, or organization would
647 experience an increase or decrease in the direct or indirect
648 financial burden or whether they would experience no change.
649 Revenue options may include, but are not limited to, the
650 following:
651 a. The redirection of current public agency expenditures;
652 b. An employer payroll tax based on progressive principles
653 that protect small businesses and that tend to preserve or
654 enhance federal tax benefits for Florida employers that pay the
655 costs of their employees’ health care; and
656 c. A dedicated revenue stream based on progressive taxes
657 that do not impose a burden on individuals who would otherwise
658 qualify for medical assistance.
659 2. The task force may explore the effect of means-tested
660 copayments or deductibles, including, but not limited to, the
661 effect of increased administrative complexity and the resulting
662 costs that cause patients to delay getting necessary care,
663 resulting in more severe consequences for their health.
664 (l) The task force’s recommendations must ensure:
665 1. Public access to state, regional, and local reports and
666 forecasts of revenue expenditures;
667 2. That the reports and forecasts are accurate, timely, of
668 sufficient detail, and presented in a way that is understandable
669 to the public to inform policymaking and the allocation or
670 reallocation of public resources; and
671 3. That the information can be used to evaluate programs
672 and policies, while protecting patient confidentiality.
673 (6) TASK FORCE TIMELINE.—
674 (a) Members of the task force must be appointed by May 31,
675 2026.
676 (b) By September 30, 2026, OPPAGA shall begin preparing a
677 work plan for the task force.
678 (c) The task force shall submit a report containing its
679 findings and recommendations for the design of the Health Care
680 for All Florida Plan and the Health Care for All Florida Board
681 to the Governor, the President of the Senate, and the Speaker of
682 the House of Representatives by the first day of the 2027
683 regular session of the Legislature.
684 (7) PLAN FOR A MEDICAID BUY-IN PROGRAM OR A PUBLIC OPTION.—
685 (a) The Agency for Health Care Administration shall develop
686 a plan for a Medicaid buy-in program or a public option to
687 provide an affordable health care option to all Florida
688 residents, with the primary focus being Florida residents who do
689 not have access to health care. To the extent feasible, the plan
690 must:
691 1. Have no net cost to the state;
692 2. Provide a comprehensive package of benefits that are, at
693 a minimum, equivalent to the benefits offered by qualified plans
694 offered through the federal health insurance exchange;
695 3. Impose no more than minimal cost sharing, deductibles,
696 or copayments;
697 4. Take into account the impact on the distribution of risk
698 in the health insurance market;
699 5. Encourage the use of premium tax credits available under
700 s. 36B of the Internal Revenue Code and other subsidies
701 available under federal law;
702 6. Maximize the receipt of federal funds to support the
703 costs of the program or option;
704 7. Use the coordinated care organization health care
705 delivery model; and
706 8. Use the coordinated care organization provider networks
707 to the extent possible without destabilizing the networks.
708 (b) By May 1, 2026, the agency shall report to the
709 Governor, the President of the Senate, and the Speaker of the
710 House of Representatives the plan developed in accordance with
711 paragraph (a), including:
712 1. A discussion of potential eligibility requirements for
713 the Medicaid buy-in program or public option, as well as the
714 implications of limiting or not limiting eligibility in various
715 ways;
716 2. Options for Medicaid buy-in programs or public options
717 targeted to specific populations, including, but not limited to:
718 a. Residents with household incomes above 400 percent and
719 below 600 percent of the federal poverty guidelines who are
720 unable to afford health insurance offered by their employers;
721 b. Residents who regularly cycle through enrolling and
722 disenrolling in medical assistance and employer-sponsored health
723 insurance; or
724 c. Other groups that face significant barriers to accessing
725 affordable, quality health care;
726 3. Recommendations for legislative changes necessary to
727 implement the plan; and
728 4. Any federal approval that will be required to implement
729 the plan, such as demonstration projects under s. 1115 of the
730 Social Security Act, a state plan amendment, or a waiver for
731 state innovation under 42 U.S.C. s. 18052.
732 (8) REPEAL.—This section is repealed on January 2, 2028.
733 Section 2. For the 2025-2026 fiscal year, the nonrecurring
734 sum of $1,174,816 is appropriated from the General Revenue Fund
735 to the Agency for Health Care Administration for the purpose of
736 implementing this act.
737 Section 3. This act shall take effect upon becoming a law.