Florida was at the center of ongoing debates and controversies dealing with health care in 2023, ranging from abortion restrictions to transgender health care to COVID-19.
Health care promises to be a hot topic in 2024 as well, kicking off with a Regular Session in January where Senate President Kathleen Passidomo's "Live Healthy" overhaul — and, along with it, hundreds of millions in spending — will be a key focus.
Below is a list of the top five health care stories of the year in Florida Politics. There were some honorable mentions: the Agency for Health Care Administration (AHCA) releasing three Medicaid managed care ITNs, Florida's ongoing physician shortage, and passage of a sweeping law regulating pharmacy benefit managers, or PBMs. But they narrowly missed the cut.
Abortion in Florida
A fierce political and legal battle over abortion restrictions was one of the dominant health care battles of 2023 in Florida — and is poised to be a major story again in the coming year.
After the U.S Supreme Court struck down Roe v. Wade, the ruling that had prevented abortion restrictions before viability, lawmakers during their Spring Session enacted a near ban on abortions after six weeks of pregnancy. That measure replaced the ban on abortions after 15 weeks of pregnancy that Gov. Ron DeSantis had just signed in 2022.
However, the six-week ban has not yet taken effect because legislators tied its implementation to resolving an ongoing legal challenge to the 15-week ban. The state Supreme Court heard arguments in the case in September but has yet to rule.
Meanwhile, those who back abortion rights have launched a citizen initiative that — if approved by voters — would prohibit abortion restrictions before viability. Organizers appear poised to get the nearly 900,000 signatures by the February deadline to make the ballot. But Attorney General Ashley Moody has asked the Florida Supreme Court to block the measure.
Trans care in Florida
The DeSantis administration continued to use its broad administrative powers to crack down on gender-affirming and gender-conforming care, defending legal challenges to SB 254, a 2023 law that makes sweeping changes to the delivery of transgender health care.
While being touted as legislation to ban transgender health care services for minors, the bill makes sweeping changes to how adults receive health care by banning the use of telehealth, requiring adults to sign informed consent forms before receiving services and limiting the list of providers who can render services to medical and osteopathic physicians only.
The Board of Medicine and the Board of Osteopathic Medicine — whose members serve at the pleasure of DeSantis — moved quickly to implement the consent forms required by the new law. But they were forced to scrap a proposed requirement that adults be required to undergo a "thorough psychological and social evaluation."
The administration also is defending the administrative steps it took in 2022 to ban gender-affirming care before the passage of SB 254.
Dropped from coverage
Florida's Medicaid enrollment dropped significantly during the past year as state officials began reexamining the rolls after the end of the COVID-19 health emergency.
The number of those getting health coverage through Medicaid grew during the pandemic because of restrictions put in place as part of higher reimbursement amounts paid by the federal government to the state.
As the emergency ended — and federal authorities began to phase out the higher funding — Florida began trimming its rolls and hundreds of thousands of residents were removed from Medicaid.
In April, AHCA reported that there were 5.77 million individuals on Medicaid. By the end of November, that had dropped by more than 14%, to 4.94 million.
The drops in enrollment, which have included children, have alarmed some health care advocates and Democrats.
In mid-December, Health and Human Services Secretary Xavier Becerra wrote to several Governors, including DeSantis, about the decrease. Becerra stated that between March and September 2023, nearly 367,000 children had been dropped from either Medicaid or subsidized children's health insurance. Becerra said that this total accounted for 17% of all children nationally who lost coverage.
Becerra urged Florida to make it easier for auto-renewals for coverage and make it easier for children to transition from Medicaid to children's health insurance programs that are part of Florida KidCare.
Pot progresses and stalls
A push to legalize marijuana in Florida made major strides as organizers behind a citizen initiative had more than 1 million voter signatures certified by election officials — far and away more than what is needed to make the ballot.
The lone hurdle left for Smart and Safe Florida, the group behind the initiative, is the green light from the Florida Supreme Court. But Moody and her attorneys tried to argue that the measure would mislead voters because marijuana would remain illegal under federal law. She urged the court to block it from the 2024 ballot.
During oral arguments in November, however, several Justices on the high court sounded skeptical about the positions taken by the state. Justice Charles Canady said at one point he was "baffled" by the assertions made by Moody's Office.
Trulieve, the state's leading medical marijuana company, spent nearly $40 million helping bankroll the effort to get the initiative in front of voters. It would be poised to expand operations if marijuana was opened up for recreational usage.
Meanwhile, the Office of Medical Marijuana Use (OMMU) didn't approve any applications for new medical marijuana licenses in 2023.
OMMU Director Christopher Kimball said the state is reviewing the applications in the two cycles currently underway and that he didn't expect decisions before April 2024. When the two licensure cycles currently underway are completed, he expected the industry to roughly double in size.
Vaccines and COVID-19
The DeSantis administration, including controversial Surgeon General Joseph Ladapo, continued to raise questions about COVID-19 vaccines. DeSantis, who rose to national prominence during the pandemic, routinely questioned the actions of federal health officials throughout the year. He also jabbed former President Donald Trump for not firing chief medical advisor Anthony Fauci when Trump was in office.
In September, DeSantis held a roundtable where Ladapo asserted that Floridians under the age of 65 should avoid taking new COVID-19 vaccine boosters that had been approved for use by federal health agencies. This position was supported by DeSantis, who said he did not want Floridians to become "guinea pigs" for booster shots that he alleged did not have evidence showing them safe or effective.
This past year, a statewide grand jury was convened at the urging of DeSantis to investigate crimes and wrongdoing associated with vaccines. That grand jury has not made any of its decisions or findings yet, but could soon.
DeSantis also was successful in urging the Legislature during the Spring of 2023 to make permanent laws that prohibit mask and COVID-19 vaccine requirements in schools and ban employer vaccine mandates and mask mandates in businesses.
As part of that package of laws, the Legislature also passed a "medical freedom" measure that would allow medical professionals to prescribe alternative treatments and would allow them to refuse to offer certain services if it offends their moral, religious or ethical beliefs.
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