2019 Legislative Preview
Florida's 2019 Issues
Ron DeSantis won the governor’s race without giving voters a clear idea of what exactly he would do once in office. One promise he made repeatedly was to clean up the state’s water, especially the polluted discharges coming out of Lake Okeechobee and into the St. Lucie and Caloosahatchee rivers. Against that backdrop, everybody in Tallahassee knows the Legislature has to do something this spring on water; the question is whether they’ll be able to agree on anything other than throwing more money at the problem and rearranging a few bureaucracies.
DeSantis’ top priority is getting a reservoir south of Lake O built, but unless the state is willing to front the federal government’s share, there may be a limit to how fast the project can move. And House leaders in recent years have resisted buying more sugar farmland for the reservoir and cannibalizing money ticketed for other Everglades restoration projects.
Meanwhile, other big policy changes — requiring stricter management practices for farmers, for example, or forcing homeowners off septic tanks and onto sewer connections — could alienate big campaign donors or large swaths of voters. There will also be scads of smaller projects and proposals in the mix, from establishing a red tide initiative at Mote Marine Laboratory in Sarasota to deep water injection wells north of Lake O.
Jose Oliva has been completely clear where he wants to flex his muscle this session: Injecting more competition into the health care system. Hospitals, in particular, are in for a beating as the House will push hard for policies such as eliminating certificates of need, allowing longer stays at non-hospital surgical centers, mandating pricing transparency, and redoing Medicaid reimbursement rates. Oliva is even exploring potential antitrust actions against some large hospital chains or challenging their non-profit status.
The House also wants to make what are known as scope of practice changes — allowing nurses, pharmacists and other health care practitioners to provide more services that currently only doctors can do. Doctors, of course, despise that idea. The scope of practice debates will pose an early test of DeSantis’ loyalties, since they pit Oliva and the Florida Medical Association — two important early supporters of his gubernatorial campaign — against each other. The Senate has in recent years been a bulwark for hospitals, and many senators will likely resist the House’s plans. But it’s a fact of life in the Capitol that when a House Speaker or a Senate president really wants something, he or she usually gets it.
Something else to watch: With a Trump ally (DeSantis) in the governor’s mansion and the Trump administration’s former Medicaid director (Mary Mayhew) now running the Agency for Health Care Administration, the Legislature may revive efforts to mandate work or community service requirements as a condition of receiving Medicaid benefits.
Bill Galvano has been at the center of the gambling debates in the Florida Legislature for more than a decade — a public policy pit of vipers in which pari-mutuels, casino developers, online operations like DraftKings and FanDuel, Disney and the Seminole Tribe annually undermine each other and poison efforts to craft any sort of comprehensive plan for the state. Now that he’s in the Senate president’s chair, Galvano would love to finally get something done. One sign of how serious he is about it: He put Wilton Simpson, who will be his successor as president, in charge of handling the issue in the Senate.
It wouldn’t be shocking to see some sort of deal in which the House gets its health care package in exchange for the Senate’s gaming package. Then again, there’s a new complication this year: Amendment 3. That was the Disney- and Seminole Tribe-backed constitutional amendment that passed in November requiring a statewide referendum for any expansion of casino gambling, which the amendment defines as the types of games typically found in casinos. The amendment all but ensures that even if the Legislature passes gambling changes — whether a long-term compact with the Seminoles, a lower tax rate on slot machines at pari-mutuels or fantasy sports betting — they’ll be met with an immediate legal challenge.
Florida’s universities should be as nervous as hospitals this session. There’s a palpable backlash building against universities, particularly in the House, where lawmakers question the wisdom of investing enormous sums of money in sprawling academic campuses. That’s a big reason why University of Central Florida administrators have faced a legislative tar-and-feathering this winter for the school’s decision to use leftover operating dollars to pay for construction projects. “I think there’s a general sentiment that health care and education are almost identical industries,” says one House member. Adds another member in House leadership: Besides health care, university funding “will get the most attention.”
University leaders can’t count on the Senate to protect them. Senate leaders say they want to put more emphasis on Florida’s community colleges this session after the schools took a beating under former Senate President Joe Negron.