Friday, September 21, 2018
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Richard Corcoran’s health care record a mixed bag

Before becoming House speaker, Richard Corcoran promised in 2015 that he was going to tackle the "Gucci-loafing, shoe-wearing special interest powers" that lobby in Tallahassee and protect the status quo.

But a look back at Corcoran's track record as speaker during the past two sessions shows that the Land O' Lakes Republican, who is known for his political acumen and ability to steer legislation through the process, didn't always come out on top with his health-care agenda.

Corcoran passed one of three health-care priorities this session, a bill (HB 37) that would allow patients and physicians to enter into "direct primary care" agreements. Two other priorities — HB 23, which would have allowed patients to stay overnight at ambulatory surgical centers and established "recovery care" centers, and HB 27, which would have eliminated Florida's "certificate of need" regulatory program for hospitals — failed to get through the Senate.

"With his tenure of service in the House and the great reputation Mr. Corcoran has, one would think that any issue that he's been supportive of would certainly pass during the legislative session," said David Shapiro, a physician, board member of the Florida Society of Ambulatory Surgical Centers and a proponent of the ambulatory surgical-center bill.

"So I'm an outside observer of the legislative process, but as disappointed I am it didn't pass, there's also an element of surprise," he said.

For political insider Mike Fasano, the Pasco County tax collector who served in the House and Senate, it's a whole lot less surprising.

"It's very difficult to achieve what you really want to achieve in two or four years," said Fasano, who met Corcoran in the 1980s when the speaker was starting the Young Republicans of Pasco County.

And If a lawmaker has future political aspirations, Fasano said, it becomes even more challenging.

Corcoran, who will leave the House this fall after eight years, is widely rumored to be running for governor, though he has not announced his candidacy.

"If you have a speaker or president of the Senate say, 'This is it. When I'm done, I'm going back home,' and they have no desire to be anything else, then you're sitting in a position that you don't care what the special interests do or don't do to you," Fasano said. "But those are the same people funding your campaign for higher office, and that's why it's even tougher. You can't go to the extremes you want to. I am not saying it's good. I'm only saying it's reality."

Corcoran had health-care success during this year's session, which ended Sunday. The Legislature passed the "direct primary care" bill after four years of considering the proposal.

Under direct primary-care agreements, doctors charge patients monthly fees in advance of providing services, with patients then able to access services at no extra charge. HB 37 does not spell out how much can be charged or what services need to be included in the agreements.

An early proponent of the "direct primary care" legislation was the National Federation of Independent Business Florida, which saw it as an option for its small business members and as an alternative to Obamacare policies on the market.

NFIB Florida Executive Director Bill Herrle said the bill was targeted for defeat in 2015 and 2016 because of bickering between the House and Senate over health-care policy.

"In every instance in the past with direct primary care, we can point to other circumstances that led to it not getting to the finish line," Herrle said. "None of those circumstances were a lack of interest or effort on his part. It is a bicameral Legislature. It's the system."

In another fiery speech from 2015, then-budget chairman Corcoran talked about "transforming" the state group health-insurance plan for state workers. And he called members who opposed the efforts at the time "protectors of the status quo."

Corcoran promised at the time that "if it is the last dying breath I have as a legislator, we will crack the status quo. And this is will be one of the ways we do it."

The Legislature passed a state group health-insurance rewrite bill in 2017, two years after the speech.

But, insiders say, Corcoran shouldn't be judged on what bills he passed. For Sal Nuzzo, vice president of policy at the The James Madison Institute, Corcoran was successful in "keeping bad stuff from happening."

"Just as important as advancing good free-market health care is making sure that policy doesn't go in the opposite direction. Opposing Medicaid expansion and disastrous effects is just as much keeping with free market principles," Nuzzo said.

Karen Woodall, executive director of the left-leaning Florida Center for Economic and Fiscal Policy, agreed with Nuzzo that Corcoran will also be remembered for leading the opposition to a Medicaid expansion in 2015.

The Senate that year had included federal Medicaid expansion money in the budget, but the House refused to go along. The discord led to a budget impasse and forced lawmakers into a special legislative session, and ultimately the state didn't expand Medicaid as allowed under the federal Affordable Care Act.

"His footprint has been to deny 800,000 low-income uninsured Floridians access to health insurance. Leaving billions of Florida taxpayer dollars in D.C. and costing Florida tens of thousands of high-paying jobs in health care," Woodall said when asked about Corcoran.

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