Mayfield: Health insurers must keep their end of the bargain

As the national debate over health insurance rages in the halls of Congress, everyone should be able to agree – no matter your political affiliation – that the benefits consumers select and pay for should be the benefits that they receive.

Yet across our state, health insurers are abruptly reducing the prescription benefits they offer to customers, raising out-of-pocket costs, requiring people to jump through additional hoops for the same medication, or removing coverage of certain treatments altogether.

In many instances, families will carefully consider their options and choose the health insurance plan that best fits their particular needs. This health insurance bait-and-switch leaves these families in limbo until the following year, when they can select a new plan.

To help solve this problem, Rep. Ralph Massullo and I have introduced H.B. 95/S.B. 182, also known as the “Bait-and-Switch Bill.” If passed, this legislation will put protections in place so Floridians can depend on their commercial health insurer to provide them with the prescription coverage that was marketed and sold to them.

At the same time, the legislation does not prevent health plans from being able to add medications to their formularies or make coverage changes if medications are removed from the market, or if drug safety concerns from the FDA arise.

There are more than 13 million Floridians living with chronic health conditions. They need access to their medications to keep their health stable. Switching to another treatment their insurer — not their doctor — prefers can destabilize them, lead to allergic reactions, and can cause them to no longer respond to treatment at all.

The Bait-and-Switch Bill is born out of stories I’ve heard from all over Florida. One story comes from a 14-year-old named Kayla, who lives with multiple chronic health conditions, including juvenile arthritis.

“I take many medications on a daily, weekly, and monthly basis,” she wrote to me. “If one of these prescriptions was to be taken away from me, I would not be able to do the things I love, like going to school.”

The reality is. without the Bait-and-Switch Bill, Kayla’s fears are justified. According to a recent Global Healthy Living Foundation survey of Floridians living with chronic conditions, 68 percent reported that their health insurer reduced coverage of the medication they were prescribed. Of these, nearly three-quarters were forced to switch to entirely different treatment, and as a result, 88 percent reported negative health consequences, nearly half missed work, and 19 percent were hospitalized.

There is a real need for reliable health coverage for Florida families, for our health care system and for our business community. In a time of uncertainty over health care, I hope my colleagues on both sides of the political aisle can come together and support this common sense piece of legislation.

Sen. Debbie Mayfield (R-Vero Beach) is a state senator representing Florida’s 17th District, and sponsor of the Bait-and-Switch Bill. Click here to view the full article.