Florida home insurance costs less with more companies
Between 2019 and 2023, average homeowner premiums in Florida surged nearly 60%.
William Large | Florida Justice Reform Institute
Condos getting hit hard by Florida’s property insurance premiums
Old Port Cove Towers condo president Mike Beck says windstorm insurance is over a million dollars in North Palm Beach building
Gov. Ron DeSantis earlier this month revealed good news when it comes to Florida’s insurance market. Yes, good news.
During the last three years, the Florida Legislature has passed meaningful reforms to address unrestrained litigation and reign in skyrocketing attorneys’ fees, and their efforts are bringing down the cost of insurance, inviting more competition into the market and giving consumers more choice for coverage on their home and auto.
Between 2019 and 2023, average homeowner premiums in Florida surged nearly 60%. Not only were homeowners paying more for property insurance, but they had access to less coverage and fewer providers to choose from.
This was partly due to a legal environment that was too friendly to lawsuits against insurers. For a long time, Florida law allowed plaintiffs’ attorneys to recover their fees if they prevailed against insurers, even if the amount they secured through litigation was minimal; these fees were “one way” because plaintiffs faced no reciprocal risk that they would have to cover the insurance company’s attorney fees if plaintiffs lost. Assignments of benefits were also misused by third parties in order to access these statutory, “one way” attorney fees.
Florida homeowners were left to foot insurance bill hikes
Unfortunately, the average Florida homeowner was left to foot the bill when insurance providers were forced to raise costs to cover excessive litigation. Many insurers determined that it was too costly to do business in Florida. By the end of 2024, more than 30 insurance providers had exited Florida’s marketplace.
The reforms began in 2021 when Senate Bill 76 required plaintiffs to notify an insurer before a lawsuit is filed. In turn, insurers are given an opportunity to reconsider a coverage denial and attempt to resolve a claim before it is the subject of litigation. The legislation also offered consumers additional protections from unscrupulous contractors.
Then in 2022, Senate Bill 2D, developed and passed during a special session called by the Governor, included additional tort reforms. This legislation prohibited assignment of the right to obtain attorney fees to anyone other than an insured or beneficiary named in the policy, thus eliminating abuse of these arrangements by third parties as a way to obtain attorney fees.
Homeowners insurance costs: Insurance still tops concerns for Floridians despite legislative changes, survey shows
Later in 2022, another special session led to the passage of Senate Bill 2A. Senate Bill 2A eliminated the statutory right to recover attorney fees in a lawsuit arising under a residential or commercial property insurance policy.
Importantly, this legislation also implemented greater protections for consumers. The law requires insurance companies to be more responsive to their customers by limiting the time they have to respond to claims.
Building on these reforms, the Florida Legislature also passed House Bill 837 in 2023 to eliminate exorbitant attorney’s fees, strengthen negligence standards and provide stronger defense to those targeted by excessive litigation.
More: Citizens Property Insurance has ‘great news’ — its business is decreasing
While our state leaders acted swiftly to develop, pass and implement solutions, we knew it would take time for these policies to stabilize the market. Now, the trends are moving in the right direction, providing much-needed relief to Florida’s homeowners.
Florida has 11 new insurance providers
In 2024, Florida had the lowest average homeowners’ premium increases in the nation, with an average statewide rate hike of just 1%. At the same time, premiums in other states have surged by more than 20%.
In addition, there are 11 new insurance providers in the market. And the providers that remain are expanding their business and filing for rate decreases.
This is only the beginning. As timelines run out for trial attorneys to pursue litigation under the more litigation-friendly law, the environment will continue to stabilize, reducing the burden of excessive litigation and bringing down costs even further.
Our state is proof that strong conservative leadership on the state level can lead to meaningful reforms. The steps our Governor and Legislature have taken are bringing stability to the market, leading to more choices and lower costs for Florida homeowners.
William Large is the president of the Florida Justice Reform Institute.
IL proposal could remove insurance companies from blocking HIV medication
SPRINGFIELD (WAND News) – A bill filed in Springfield would allow doctors to prescribe some HIV medication without needing prior authorization.
Prior authorization is when doctors need the approval of insurance companies before they can prescribe drugs. The American Medical Association says insurance companies use prior authorization to save money.
The plan would allow doctors to prescribe some drugs that have been shown to reduce deaths from HIV. State Rep. Kelly Cassidy (D-Chicago) said she doesn’t want to return to the deadliest days of the disease.
“My experience in the eighties I became somebody who has been to as many funerals as most peoples grandparents have at this point,” Cassidy said. “I don’t want to go back there. I want us to go to zero and we can.”
Some Republicans in the committee were opposed to the proposal, saying prior authorization is there for a reason.
“At the front end we’re saying here we’re going to give you this stuff to engage in risky behaviour,” State Rep. Jeff Keicher (R-Sycamore). “I’m not saying that’s everybody, but we’re giving a preventative without prior authorization and I think that’s a slippery slope.”
The bill passed out of the House insurance committee with a 13-3-1 vote with two Republican lawmakers voting yes. It now heads to the House floor were lawmakers could talk about it in the coming weeks.
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The delicate balance between money and health care
In February, SmartBrief readers turned their attention to stories showing how intricately health care and finances intersect – and are interdependent. There was news of the fiscal strain that states are feeling over the coverage of costly weight loss drugs, Americans’ concerns about pricing and access to health services, and how insurance executives’ pay can be tied to customer satisfaction. Readers also were interested in poll results showing how artificial intelligence can generate return on investment for health systems.
Drug costs weigh on state budgets
What happened: High demand for weight loss drugs such as Wegovy and Ozempic is placing financial stress on some states that cover the medications for their employees. States such as West Virginia, Colorado and North Carolina have either considered dropping coverage or have already done so due to high costs and budget tightening. Employee groups have pointed out that ending the coverage likely will cost states in other ways, including a less healthy and productive workforce and greater outlays to treat obesity-related disease.
What’s next: It was reported earlier this year that Ozempic and Wegovy will be included in the next round of Medicare drug price negotiations, with the new pricing taking effect in two years. In the meantime, manufacturers Novo Nordisk and Eli Lilly & Co. have announced more immediate price reductions for Wegovy and Zepbound, respectively, and the FDA formally stated that the semaglutide shortage has ended.
Americans worry about care costs, access
What happened: A Gallup survey found that health care access and affordability were the most pressing public health issues for about a quarter of respondents. Eighteen percent said safe food and water supplies were their main concern, and 11% said reducing chronic disease was their biggest priority. The survey also shed light on how public health priorities align with people’s political leanings.
What’s next: A fifth consecutive Medicare pay cut for physicians was announced recently, reducing their payment by 6.3% and raising further questions about declining access to care. Rep. Gregory Murphy, R-N.C, commented in a Forbes analysis that American physicians are “struggling like never before” due to these cuts, potentially causing millions to lose access to affordable services, with older adults among the most deeply affected.
Insurance execs’ pay to hinge on feedback
What happened: Health insurance giant Cigna announced that its executives’ compensation will be tied to customer satisfaction, part of an effort to improve health care access, affordability and engagement. High-level officers’ bonus awards will depend on the company’s net promoter score, a metric for customer satisfaction and loyalty. The company also outlined plans to hire more care navigation experts, streamline prior authorization and claim processes, and improve its digital portal for clinicians.
What’s next: Cigna said it will release a report early next year to evaluate progress on these initiatives, and it is creating an Office of Excellence and Transformation to oversee them. An Insurance Business report from late 2023 shows which US health insurance executives are the highest-paid.
AI generates ROI for some health systems
What happened: A Deloitte poll of health care executives found that 4 of 10 have seen “significant to moderate” return on investment from the use of generative AI technology, while 37% said they felt it was too early to report on ROI, and 12% said they had noted little ROI so far. Systems are using the platforms to automate tasks such as data entry, clinical documentation and medical imaging analysis.
What’s next: Fortune Business Insights research predicts that the worldwide health care AI industry will balloon from about $28 billion to more than $490 billion in the next seven years. Data from the National Bureau of Economic Research suggest that wider adoption of AI could reduce the nation’s health care spending by hundreds of billions of dollars a year.
Can House Republicans cut $880 billion without slashing Medicaid? It’s likely impossible.
The prospect of deep Medicaid cuts has become a flashpoint in Congress, with leaders of both parties accusing their counterparts of lying.
House Democratic leader Hakeem Jeffries said Feb. 27 that a Republican budget measure would “set in motion the largest cut to Medicaid in American history,” and that Republicans are hiding the consequences.
“The Republicans are lying to the American people about Medicaid,” Jeffries said. “I can’t say it any other way. Republicans are lying. Prove me wrong.”
Republicans said Democrats were distorting the Republican budget. Rep. Steve Scalise (R-La.) said, “The word ‘Medicaid’ is not even in this bill.” House Speaker Mike Johnson said on CNN that Republicans don’t want to cut Medicaid, “and the Democrats have been lying about it.”
Republicans are looking for massive budget savings to meet their goal of fully extending President Donald Trump’s 2017 tax cuts. This is a separate process from Congress’ need to pass a continuing resolution to keep the government running by March 14 or face a federal government shutdown.
Here’s what we know so far about potential Medicaid cuts.
The House GOP budget plan seeks $880 billion in cuts
Medicaid serves about 1 in 5 Americans. The health care program for low-income people is paid for by the federal government and partly by states. Louisiana, home to Johnson and Scalise, has one of the highest state proportions of Medicaid enrollees.
The House Republican budget plan adopted Feb. 25 opens the door to slashing Medicaid, even though it doesn’t name the program. The plan directs the House Energy and Commerce Committee to find ways to cut the deficit by at least $880 billion over the next decade.
The committee has jurisdiction over Medicaid, Medicare, and the Children’s Health Insurance Program, in addition to much smaller programs. CHIP offers low-cost health coverage to children in families that earn too much money to qualify for Medicaid.
Republicans ruled out cuts to Medicare, the health insurance program for seniors that leaders cut at their political peril. Medicare is about 15% of the federal budget, and Medicaid is about 8.6%.
When Medicare is set aside, Medicaid accounts for 93% of the funding under the committee’s jurisdiction, the nonpartisan Congressional Budget Office found in a March 5 analysis. That means it is impossible for the committee to find enough cuts that don’t affect Medicaid.
“It’s a fantasy to imply that federal Medicaid assistance won’t be cut very deeply,” said Allison Orris, an expert on Medicaid policy at the Center on Budget and Policy Priorities, a left-leaning think tank.
After Medicaid, the next-largest program under the committee’s jurisdiction is CHIP. Lawmakers don’t appear to be planning to wipe out CHIP, but even if they did, they would be only a “fraction of the way there,” said Joan Alker, an expert on Medicaid and CHIP at Georgetown University.
If Medicare cuts are off the table, the only way to achieve $880 billion in savings is through big Medicaid cuts, said Larry Levitt, executive vice president for health policy at KFF, the health policy research, polling, and news organization that includes KFF Health News.
Andy Schneider, a professor at Georgetown University who served in the Obama administration as a senior adviser at the Centers for Medicare & Medicaid Services, said even if the committee eliminated all those “other” programs entirely it could achieve only $381 billion in savings — about 43% of the target.
“In short, if they don’t want to cut Medicaid [or CHIP], and they don’t want to cut Medicare, the goal of cutting $880 billion is impossible,” Schneider said.
The $880 billion cut is not a done deal. House Republicans were able to pass their budget package, but Senate Republicans are taking a different approach, without proposing such significant cuts.
Any finalized budget blueprint would need Senate Republicans’ buy-in. Sen. Josh Hawley (R-Mo.) is among Republicans who have spoken against potential cuts; he told HuffPost, “I would not do severe cuts to Medicaid.”
The numbers are starting points that may lead to negotiation among at least Republicans, said Joseph Antos, a health care expert at the conservative American Enterprise Institute. “We are a long way from final legislation, so it’s not possible to predict how much any program will be cut,” he said.
“If the bill also includes extending the [Trump 2017] tax cuts, we are probably months away from seeing real language,” Antos said.
Once the House and Senate have reached an agreement on language and the resolution passes both chambers, the committees will work on detailed cuts. To enact such cuts, both chambers would need to approve a separate bill and receive Trump’s signature.
Why eliminating fraud doesn’t solve the problem
Republican leaders have deflected concerns about Medicaid cuts by talking about a different target: Medicaid fraud.
“I’m not going to touch Social Security, Medicare, Medicaid. Now, we’re going to get fraud out of there,” Trump told Fox News’ Maria Bartiromo on March 9, in keeping with his campaign rhetoric that he would protect those programs.
At the same time, Trump on his Truth Social platform praised the House resolution that would make cuts highly likely: “The House Resolution implements my FULL America First Agenda, EVERYTHING, not just parts of it!”
Would eliminating fraud solve the Medicaid problem? No.
On CNN, Johnson said cutting fraud, waste, and abuse would result in “part of the savings to accomplish this mission.” He said the government loses $50 billion a year in Medicaid payments “just in fraud alone.”
Johnson conflated “fraud” with “improper payments.” The Government Accountability Office, the nonpartisan investigative arm that examines the use of public funds, found about $50 billion in improper payments in Medicaid and the same amount in Medicare in fiscal 2023.
Those improper payments were made in an incorrect amount (overpayment or underpayment), should not have been made at all, or had missing or insufficient documentation. But that doesn’t mean that there was $50 billion in Medicaid fraud, which would involve obtaining something through willful misrepresentation.
The system used to identify improper payments is not designed to measure fraud, so we don’t know what percentage of improper payments were losses due to fraud, said Schneider, the former Obama administration health adviser.
Plus, it’s a drop in the overall bucket of the potential $880 billion in cuts.
This article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling, and journalism.
Portland family stunned by health care industry price markups
A Portland family argues that their $430 walking boot illustrates the problem of inflated costs in health care, where prices are obscure and detached from reality.
PORTLAND, Ore. — When Jennifer and Bryan Alger’s son got hurt playing soccer, the Portland couple did what most parents would — they took him to the doctor.
“We went straight from the soccer field to urgent care,” said Jennifer Alger.
The treatment was straightforward. The 13-year-old broke his foot and was given a walking boot. “We didn’t think it was going to be a large ticket item,” explained Jennifer.
Then came the bill. A Eugene-based company called Synergy Medical Systems demanded a payment of $129 for the walking boot.
At first, Jennifer and Bryan Alger thought maybe the invoice was for insurance to pay, not them. So, they asked for an itemized bill. It showed insurance had already agreed to pay $300, and their co-insurance, the amount insurance didn’t cover, was $129. Which meant that walking boot cost a total of $430.
“This is a company that is taking advantage of families at their most vulnerable times,” said Jennifer.
Keep in mind, this is not a particularly complicated device. The exact same walking boot, an Ossur Formfit Walker Air Boot, is available online for about $50. Amazon sells it for $64.99.
“My expectation is that I’m going to be charged a reasonable market rate. I don’t expect that I’m going to be taken advantage of when I go to the ER or urgent care,” Jennifer said.
The Algers contacted Synergy and asked the company to withdraw the $129 bill — not because they couldn’t pay, but because they felt Synergy had already collected enough from insurance.
“Is this the company that you’re trying to be?” asked Bryan Alger. “Take advantage of people when they really don’t have options or choices?”
So far, Synergy isn’t budging on the bill. It claims the family signed a waiver at urgent care, agreeing to pay whatever insurance didn’t cover.
“Whenever we go to get our care, we are forced to sign a blank check,” explained Cynthia Fisher, founder of the nonprofit PatientRightsAdvocate.org.
Fisher said health care is one of the few industries that tells you what things cost after the fact.
“As long as hospitals and insurance companies hide their prices, they can charge whatever they want,” Fisher said.
When asked to explain, Synergy referred KGW to its partner company, AMC Billing Services.
“We bill at the Medicare standard rate,” wrote Brittany Fonesca, billing manager for AMC Billing Services in an email to KGW. Fonesca explained insurance has the final say on the cost of durable medical equipment.
Insurers often contract with certain medical supply companies to provide equipment, just as they negotiate rates for other services.
The Algers’ insurance company, PacificSource, declined to comment.
The urgent care in Cedar Hills, Legacy-GoHealth Urgent Care, explained it publishes rates for common procedures when paid in full at the time of service and customers can reach out for an estimate of actual pricing.
“For those with health insurance seeking non-emergency care, patient responsibility — or out-of-pocket cost — is based on your specific insurance coverage and plan,” said Scotty Sonntag, vice president of operations for Legacy-GoHealth Urgent Care. “We strongly recommend that customers contact their insurance carrier for details about plans and coverage, including copays, before visiting to understand financial responsibility.”
“If I were to do it again, I would have declined taking it and just ordered it and had it the next day,” said Jennifer.
Patient advocates suggest, if possible, that consumers ask about pricing. Find out who is supplying the equipment, if they’re in your insurance network and how much you’ll owe out-of-pocket.
If you can wait, pull out your phone and compare prices.
“You can say, ‘I refuse,’” said Fisher of PatientRightsAdvocate.org. “I’ll have it delivered to my door in a couple of hours. We are empowered to do that. We can do that.”
Alternatively, consumers can avoid buying new equipment by asking family or friends if they have a wheelchair, crutches or knee brace at home that can be borrowed.
Several nonprofits in the Portland area, including A Caring Closet, provide used durable medical equipment for free to those in need. Thrift stores also sell certain used medical equipment such as walkers, canes and crutches.
Jennifer and Bryan Alger feel this $430 walking boot helps illustrate a broken health care system — one where profits come before patients.
Your name doesn’t have to be Luigi for you to feel vitriol toward the insurance industry, including auto insurers. Car owners can’t catch a break at all. The average cost of full coverage increased by 26 percent last year, and that’s on top of a 24-percent increase in 2023. Understandably, drivers paying through the nose don’t feel like they are getting their money’s worth and struggle to have their claims covered when they file them.
What’s your worst car insurance story? There are countless ways that insurers can take advantage of car owners, from ridiculous premium increases to claims rejected for seemingly no reason. Did an insurance company refuse to insure your car because of the make? This is something that happened to Hyundai and Kia owners two years ago when thefts spiked by 1,450 percent in St. Louis and then spread nationwide as the Kia Boyz social media trend made millions aware of an automaker security exploit.
Insurance companies bought your driving data for next to nothing
rblfmr/Shutterstock
Your hard-earned dollars aren’t the only thing insurers are taking? Automakers are also selling our data to insurance companies. Last year, two U.S. Senators sent a letter to the FTC calling out GM, Hyundai and Honda for collecting vehicle data from drivers. These manufacturers would then sell this information for shockingly low sums of money to analytics firms. Insurers would then use the data to set the rates for specific models. Hyundai made 61 cents per car from selling driving data, and Honda took in 26 cents per car. Soon afterward, GM stopped collecting driving data.
Don’t hold back, but please don’t make actionable threats against executives. Tell us about your worst interactions with car insurance companies in the comments below. Be sure to mention the year, make and model of the vehicle involved so we can make our own assessment of the situation. We can’t wait to read the horror stories you have to offer.
Military families face four key health care deadlines by March 31
Military families have two weeks to meet March 31 deadlines for four important tasks related to their health care.
Enroll in a health care flexible spending account: In a special enrollment period through March 31, active duty service members have the option of enrolling in a health care flexible spending account, a new benefit that could help defray their out-of-pocket health care costs.
A health care flexible spending account, or FSA, is a savings account that can be used to pay for items not covered by health or dental insurance.
Service members can contribute any amount between $100 and $3,300 in pretax earnings this year toward eligible health care expenses, and then submit receipts for those expenses to be reimbursed from their account. Each year, the Internal Revenue Service determines eligible expenses and contribution limits.
By contributing to FSAs, the taxable income decreases by the contribution amount. Savings average 30% on eligible health care expenses, according to the Federal Flexible Spending Account Prog?am, or FSAFEDS, which administers the FSA program for the Defense Department and other federal agencies. Visit www.fsafeds.gov for more information and to enroll.
Download health records from the Tricare Online Patient Portal: The TOL Patient Portal will be shut down on April 1 and replaced by the Defense Department’s new electronic health record, MHS Genesis. To keep a copy of legacy health records, beneficiaries must download them by March 31. All military hospitals and clinics have made the transition to MHS Genesis, and the previous records won’t transfer to MHS Genesis. However, providers will continue to have access to the complete health records, according to the Defense Health Agency.
Beneficiaries can also request a physical copy from their military hospital or clinic’s records management office by completing a request form in person, then returning at a later date to pick up the records. Starting April 1, to get access to your legacy records, you’ll have to complete this process.
To download the records, visit www.TRICAREOnline.com, and log in using the required credentials. The web page provides instructions.
Beneficiaries in the Tricare West Region must set up their payment with TriWest: Beneficiaries who pay for their Tricare coverage using a bank electronic funds transfer, credit card or debit card, must provide that information to the new West Region contractor, TriWest Healthcare Alliance. Officials extended the deadline to March 31 following beneficiaries’ difficulty in accessing the TriWest web portal and other issues.
This affects certain beneficiaries enrolled in Tricare Prime, Tricare Select, Tricare Young Adult, Tricare Reserve Select and Tricare Retired Reserve. Officials have assured beneficiaries that if they pay by allotment, their allotments will be transferred automatically to TriWest from the previous contractor. That hasn’t happened for some people, Military Times previously reported, and beneficiaries should check their pay statements for allotment information. The payment requirement affects all West Region beneficiaries, including those in the six states that moved to the region: Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin.
Visit the TriWest secure portal at www.tricare.mil/west, select “Sign up as a new user or log in” and follow the instructions. For assistance, call TriWest’s customer service center at 888-874-9378.
The West Region referral waiver period ends soon, so use Tricare Prime referrals for specialty care before March 31: Amid issues with TriWest, officials temporarily suspended a rule requiring beneficiaries to get their referrals to specialists approved, essentially allowing Tricare West Prime beneficiaries to bypass TriWest in order to get specialty care. This is retroactive to Jan. 1. The waiver doesn’t apply to some inpatient care and some specialty care, such as applied behavior analysis or autism care demonstration services.
The process is different for those with referrals and authorizations issued before Jan. 1 by the previous contractor. Those will be accepted through their expiration date or June 30, whichever comes first.
Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book “A Battle Plan for Supporting Military Families.” She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.
AI Tools Promise Better Care but Challenge Safety-Net Providers
A physician at a Federally Qualified Health Center talks to a patient while adding notes to her medical record. AI “ambient scribing” technologies are being used by a growing number of health systems to ease the burden on physicians of entering detailed patient visit summaries into electronic health records. Photo: Jessica Brandi Lifland
Artificial intelligence (AI) is swiftly reshaping the health care landscape, but the impressive array of helpful new tools is not equally accessible to everyone. While private hospital systems and commercial insurance plans can afford technologies that could alleviate burdens on their workforce and improve patient care, California’s health care safety net is at risk of being left behind. It’s a problem that worries the people who run the medical and social service organizations that serve millions of Californians with low incomes.
If safety-net institutions miss out on the potential of AI, it could widen persistent racial and ethnic health disparities in that population, said Stella Tran, senior program investment officer at the CHCF Innovation Fund. “It would be a tale of two health systems,” she said.
The potential applications of AI are significant: Ambient note-taking technologies that could reduce burnout and give providers more face time with patients. Chatbots that could offer speedier access to care. Tools that could assist with diagnostics and help predict patient health outcomes. Many others are being developed as well.
CHCF wanted to learn more about spreading AI equitably, so it partnered with the California Health and Human Services Agency to listen to 45 safety-net leaders from across the state. In three focus group sessions conducted between August and October 2024, leaders of managed care plans, hospitals, community clinics, and community-based organizations offered their perspectives on AI. There was a strong desire to share their experiences and perceptions. “We had one clinic leader drive over three hours each way to be at the table,” said Katie Heidorn, CHCF’s director of state health policy.
Safety Net Access to AI
The lively strategic discussions, which offered confidentiality to encourage candor about sensitive issues, confirmed that safety-net organizations face restrictive barriers to the safe and effective adoption of AI. Those obstacles include prohibitive costs, workforce limitations, and concerns about liability.
Participants shared the capabilities of AI that excite them, offered use cases, and commiserated over challenges — especially the need for increased resources to help safety-net institutions rapidly adopt AI tools that could improve their services. Many said their organizations cannot afford to integrate new digital tools into their workflows. “The pricing models don’t work for the safety net,” said Kara Carter, CHCF’s senior vice president for strategy and programs. AI products that charge per usage or per provider visit are currently too expensive for safety-net organizations, she said, adding, “That’s going to have to change.”
Participants also explored group purchasing and other strategies to access AI products. One solution could be for vendors to offer discounts to safety-net organizations, perhaps by partnering with other AI companies to create bulk deals, said Heidorn.
But that method wouldn’t ease the infrastructure and personnel requirements, she said. Few safety-net organizations can afford to hire expert staff to oversee AI implementation.
Well-resourced hospital systems have large data management capacity, with large IT departments and data science staff at their disposal. “A community clinic may not have the data scientists on staff needed to implement AI,” said Tran.
Because safety-net organizations are already burdened by projects aimed at improving infrastructure and care delivery, the surge in AI technology is causing a sort of paralysis, participants said. Organizations may need to put AI adoption on the back burner because they are prioritizing the enhancement of other technical capabilities, such as data exchange.
Nimble Organizations Take More Risks
“Across the board, there are underlying problems in infrastructure,” Carter said. “But if we wait to move on AI until we fix all of those, we miss the boat.”
The sessions revealed that nimble organizations with simpler structures and decisionmaking pathways feel freer to take risks with AI, such as a small community health worker organization that created its own generative AI tools because commercial options didn’t suit their specific needs.
Providers say they often hesitate to purchase AI tools because the financial benefits are unclear. “We need to find examples of return on investment and share them widely to make the case for AI really clear,” Tran said.
Ambient scribing improves physicians’ quality of life by reducing the time needed to write patient notes after hours. Hospitals and health systems, however, assign less value to savings generated by physicians who were volunteering their time anyway. Yet when the tool is framed as a way to bolster employee retention, other cost savings become clearer. “What is the cost of losing the doctor? Or of hiring a new provider?” Tran said. Taken further, employee retention yields savings by ensuring that patients can be seen in a timely fashion, and therefore possibly avoid developing more complex conditions that are expensive to treat.
Examining returns on investment this way reflects lessons learned from mistakes of the past, CHCF leaders said, pointing to missed opportunities when electronic health record (EHR) systems were introduced two decades ago. That process resulted in discrepancies in the implementation of EHRs in well-resourced versus safety-net systems. “It was fragmented, and it wasn’t made for effective data exchange,” said Carter. “Those mistakes have been really expensive to fix.”
The listening tour showed that safety-net organizations already see the AI revolution as an opportunity to do things differently, Carter said. “I was thrilled to hear that sentiment from participants,” she said.
Top Worries About AI in the Safety Net
But as eager as they are to seize AI opportunities, several concerns about access and equity remain top of mind.
First and foremost, safety-net providers are worried about who bears the financial risk for AI errors. They said the state should establish accountability guidelines showing which parties are responsible for the safety of the technology. “They’re concerned about risk if it messes up,” said Heidorn.
The path of least resistance may be to put the onus on health organizations rather than on AI developers because health care providers are already accustomed to being heavily regulated, Heidorn said. But that might create a chilling effect in which safety-net organizations avoid AI out of liability fears, she said.
On the other hand, laying too much financial risk on developers might deter innovators from tackling safety-net problems. Some form of safe harbor for providers and developers alike may be the sensible path forward, Carter said. “Organizations want to be able to try and fail, and that is hard to do without clear accountability,” she added.
Safety-net organizations need to be included in data exchange networks, and their patient data should be used to train AI models to counter racial and ethnic biases, Carter said. Small clinics need to have access to the same large data resources that well-resourced systems have, and AI innovators need to ensure that their technologies prioritize primary care. “We can’t be leaving out the part of the infrastructure that safety-net patients interact with the most,” Carter said.
Likewise, attention needs to be directed to ensuring that certain regions and populations aren’t left out of these digital advances. The Central Valley and rural Northern California, for instance, suffer from poor broadband connectivity, affecting organizations’ abilities to implement new AI technologies. Participants from Southern California emphasized the challenges of sharing data between Los Angeles County’s many systems, while those from the Central Valley spoke of the need for data exchange programs that can follow the movements of farmworkers. And regions with sizable immigrant populations are concerned about the technologies reaching those who speak languages other than English. Designing AI tools that can address these barriers will help to shrink health care’s existing digital divide.
Extensive Dialogue Needed
Crafting new policies will require extensive dialogue among lawmakers, safety-net providers, and AI developers. “There are information gaps on all sides,” Heidorn said. “We need to ensure that lawmakers are educated in AI, and that the AI learnings specific to health care are passed on to the state.”
So far only health care leaders and providers have had input on AI, so CHCF plans to host listening sessions with safety-net patients to understand their perspectives, said Heidorn. That will help policymakers, developers, and safety-net leaders ensure that the deployment of AI is tethered to the future of health equity. Already, Medicaid enrollees have worse health outcomes than those with commercial coverage — and if Medicaid patients are unable to reap the same benefits of AI tools as commercial health systems, those disparities will worsen. What’s more, in the face of workforce shortages, primary care deserts, and other critical health care problems facing the state, AI could help the Californians with lower incomes edge closer to having equitable access to care.
The safety net needs to be given a seat at the table, CHCF leaders said. “AI can address long-standing issues in our delivery system,” said Tran, “and we want to make sure our corner of the world has access to that.”
Robin Buller
Robin Buller is an Oakland-based writer, researcher, and editor. She has reported on harm reduction, maternal health, migration, housing, and policing for The Guardian, The Oaklandside, and other publications. Read More
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Jessica Brandi Lifland is a freelance photographer, instructor of journalism at City College of San Francisco, and mother. Her work with publications and nonprofits such as Operation Smile, Tostan, and the California Health Care Foundation has taken her all over the world, including West Africa, the Middle East, Kosovo, Burma, Haiti, and South America. Read More
Lawmakers Debate Overhaul Of Attorney Fees In Home Insurance Lawsuits | NewsRadio WFLA
FLORIDA – Florida legislators are once again debating the rules surrounding legal fees in property insurance disputes, reigniting a battle over whether homeowners should have greater power to challenge insurance companies in court.
The House Civil Justice & Claims Subcommittee voted 16-1 on Thursday to advance HB 1551, a bill that could reverse a 2022 law that shielded insurance providers from paying homeowners’ legal fees in coverage disputes.
While the insurance industry contends that the law helped stabilize Florida’s market by limiting lawsuits, consumer advocates and some lawmakers argue that it unfairly tilts the legal system in favor of insurers, making it harder for policyholders to fight claim denials.
The proposed legislation aims to create a “loser pays” system, where the losing party in an insurance lawsuit would be required to cover the other side’s attorney fees.
Supporters of the measure argue that the current law makes it financially risky for homeowners to sue insurers, even in cases where their claims were wrongfully denied.
Opponents, including major industry groups like the Florida Insurance Council, the Florida Chamber of Commerce, and the Personal Insurance Federation of Florida, argue that rolling back the 2022 reform could lead to an increase in lawsuits, causing financial instability in the insurance market.
Prior to the legislative changes, Florida saw a surge in litigation, which insurers claimed contributed to rising costs and even forced some companies into insolvency.
By eliminating the one-way attorney fee system, lawmakers had hoped to reduce unnecessary lawsuits and lower premiums for consumers.
The bill must clear two additional House committees before it can advance to a full vote.
A companion measure, SB 426, introduced by Sen. Jonathan Martin (R-Fort Myers), is also making its way through the Florida Senate.
WV Navigator hosting event to help those dealing with recent job loss
PARKERSBURG, W.Va. (WTAP) – WV Navigator will be hosting a free event for those needing health insurance.
The event is a free, in-person health coverage enrollment event to assist with ACA Marketplace Health Insurance sign-ups. It will run from 10 a.m. to 6 p.m. at the Vienna Public Library. Representatives will be available for assistance during the entire event.
No appointment are necessary and walk-ins are welcome throughout the dy.
Jeremy Smith, Program Director for WV Navigator, emphasizes the importance of seeking guidance during the enrollment process.
“Many people feel overwhelmed by their options or don’t know how to shop for affordable health coverage,” Smith says. “Expanding outreach efforts has helped our program grow significantly—our enrollments have increased by over 114% compared to last year. More people are realizing that these are legitimate, affordable plans,” said Smith.
The Affordable Care Act’s Health Insurance Marketplace allows anyone who has recently lost health insurance coverage to sign up within 60 days of their loss.
Individuals not eligible for Medicare, Medicaid, or employer-based insurance may qualify to purchase coverage under ACA provisions. Medicaid enrollment is available year-round for those who meet eligibility requirements.
WV Navigator, a federally funded nonprofit, provides free assistance in selecting a plan and applying for financial aid that helps reduce monthly premiums.
Currently, 97% of Marketplace enrollees receive subsidies, making coverage more affordable. New subsidy rules have expanded eligibility, allowing even higher-income individuals to qualify for lower-cost plans. Four in five people can find plans for less than $10 per month.
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