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As Florida’s legislature gears up for its 2024 session, several key issues loom large on the horizon, demanding decisive action from lawmakers. Amidst a packed agenda, a focus on health care, artificial intelligence, property insurance, and potential constitutional amendments raises substantive questions and challenges.

Health Care: Can Lawmakers Strike a Balance Between Innovation and Accessibility?

According to top brass in the Capitol, legislation on bolstering Florida’s healthcare ecosystem is expected to take top priority across the coming sixty days, capped by Senate President Kathleen Passidomo’s ‘Live Healthy’ policy package.

During the $1 billion legislative plan’s rollout, Passidomo directed attention to what she referred to as the inadequacy of insurance coverage alone in guaranteeing access to healthcare and identified technology as a potential tool to refine healthcare workforce productivity and delivery.

“Access to health care is important at every phase of life. Insurance does not guarantee access, as even Floridians with great insurance face barriers to care. Live Healthy is a robust package of policy enhancements and strategic investments that will help make sure Florida’s healthcare workforce is growing at the same pace as the rest of our state,” she said.

However, a question remains: Will these initiatives suffice in addressing the immediate care needs of Floridians, particularly against the legislature’s decision against Medicaid expansion? With Florida ranking among the top states for uninsured residents, the absence of Medicaid expansion in the legislative package presents a potential point of contention among the total collection of lawmakers.

A secondary feature of Live Healthy is expanding the state’s healthcare workforce through the enlargement of the FRAME program, designed to retain healthcare professionals in Florida with increased loan repayments. It additionally extends dental student loan repayments to private practices in underserved areas and simplifies the process for out-of-state APRNs and PAs to practice in Florida. A new Graduate Assistant Physicians (GAP) licensure for medical school graduates awaiting residency was also introduced.

In a memorandum issued to lawmakers in November, Passidomo highlighted a shortfall in healthcare professionals, with an anticipated deficit of nearly 18,000 physicians by 2035. Per the memo, Florida’s projected healthcare workforce would meet just 77 percent of the state’s needs. The nursing sector faces a similar crisis, she wrote, with forecasts indicating a shortage of 37,400 registered nurses and 21,700 licensed practical nurses by the same year.

“[O]ur estimates suggest that over the next five years, our population will grow by almost 300,000 new residents per year,” she said. “While this growth will impact so many areas of public policy, my focus for the upcoming session will be on our health care system. Specifically, growing Florida’s health care workforce, increasing access, and incentivizing innovation, so Floridians can have more options and opportunities to live healthy.”

The urgency to retain graduating medical students overlooks the crux of the issue, however, failing to ask why a substantial portion are opting to leave the state.

Artificial Intelligence: Navigating New Legislative Frontiers

Emerging as an impossible-to-ignore point of discussion, artificial intelligence (AI), particularly in business growth and political advertising, faces a challenge in introducing laws that ensure transparency and prevent misuse. With many people largely unfamiliar with the harnessing power that AI provides, the way in which lawmakers approach this new tech frontier will be fascinating.

Interestingly, in a conversation with former Republican lawmaker Jeff Brandes in December, he indicated that his party colleagues appear fearful of AI, rather than accepting of its adoption.

“I think my general sense of Republicans is more fearful of AI than they are an acceptance amongst my legislative colleagues,” said Brandes. “I think you’re gonna see some bills on AI this year. I don’t know how effective they would be at actually doing anything substantial but I think you’re going to see some legislation which relates to that.”

The speculative sentiment alluded to stands contrary to what tech leaders advocate for, as seen in their urging for Florida to significantly invest in AI to maintain economic growth. At the Florida Chamber of Commerce’s annual summit last October, Saif Ishoof, founder of Lab22c, focused largely on the centrality of AI and similar emerging technologies in current business trends, warning of the economic repercussions the state could face should underinvestment persist.

“It’s incumbent upon every one of us to become fluent with these next frontier technologies,” said Ishoof.

Several bills have already been filed, primarily focusing on AI transparency. Sen. Joe Gruters introduced legislation last month that seeks to regulate and standardize the use of artificial intelligence (AI) across state government agencies. Moreover, the measure lays the groundwork for a uniform approach to AI deployment and governance within the state. A primary provision involves the formation of an Artificial Intelligence Advisory Council, to be housed within the Department of Management Services.

The council would be tasked with several key functions: evaluate the need for legal reforms and establish an ethics code for AI use in state government; study the impact of AI on the rights of Florida residents; assess potential benefits and risks of AI for the state, its people, and businesses; and recommend policies to promote AI development in Florida.

A separate AI-focused bill was filed by Sen. Nick DiCeglie, which mandates that any political advertisements, including electioneering communications that utilize generative AI to create content, must prominently include a disclaimer stating it was created utilizing the technology.

DiCeglie’s bill would also authorize the filing of complaints regarding violations with the Florida Elections Commission and would require expedited hearing procedures for such complaints.

While early filings center around transparency, how lawmakers tap into the economic and efficiency advantages will be something to keep an eye on during Session.

Insurance: Seeking Stability in a Turbulent Market

The property insurance crisis in Florida remains a hot-button issue, with homeowners facing steep rate hikes and coverage challenges. Despite previously enacted measures, the market’s instability persists.

During the aforementioned conversation, Brandes noted the need for minor legislative adjustments to clarify existing insurance laws, and underscored the importance of ensuring Citizens Property Insurance Corp rates that are “accurately sound, at least for new business.”

“I think you’re already seeing the governor come out with his proposals as it relates to the reduction of taxes on property insurance, whether that be flood insurance, dealing with the FICA assessment, or scaling back the insurance premium tax on an annual basis,” Brandes said. “You’re starting to see the governor, in the budget, [do] what he can do to reduce costs for Floridians. Now, are they going to have a dramatic effect? Time will tell; Unlikely, but it is something that they can do.”

With approximately 15 to 20 percent of homeowners opting to self-insure their homes, Brandes pointed to the need for more competition in the state insurance market to drive down prices, insinuating that the market’s lack of profitability serves as a barrier to investment and new entrants.

“The only way you’re going to get more competition is for the Florida insurance market to be seen as profitable,” he said. “It hasn’t been profitable for the last five years; we’ve lost almost $5 billion in capital in the last five years. Nobody is willing to invest in that market.”

Lawmakers have urged patience to allow reforms to settle the market, but as families grapple with soaring premiums, there’s growing concern that the auto insurance market could be the next battleground.

Recent legislation aimed at stabilizing the property insurance market, which benefitted many insurers, has also sparked anticipation in the auto insurance sector, with some experts predicting a similar crisis on the horizon.

Notably, many of the property insurers, who are now stabilized on firmer ground, also offer auto insurance policies. This overlap raises questions about potential legislative moves that could impact the auto insurance market, as insurers and consumers alike watch closely for changes that could affect premiums and coverage options.

Constitutional Amendments: Changing the Rules of Voter Approval

Ahead of Session, lawmakers renewed an effort to increase the threshold for voter approval from the current 60 percent to 66 percent. A Joint Resolution filed in November seeks to amend the State Constitution to allow for the higher approval threshold. Will this be the year it sticks?

The proposal outlined in the resolution would be presented to Florida voters during the next general election or an earlier special election, provided that one would be deemed necessary.

“Proposing an amendment to the State Constitution to increase the percentage of elector votes required to approve an amendment to or a revision of the State Constitution from 60 percent to 66.67 percent,” reads the proposal, as it would appear on ballots.

If the proposed amendment receives the required rate of approval by voters, it would go into effect on the first Tuesday after the first Monday in January following the election. Alternatively, it could come into effect on another date if specified in the amendment or revision.

In Florida, there are several methods to propose amendments to the state constitution. Citizens can initiate a constitutional referendum by collecting signatures from registered voters, with the required number being a proportion of votes from the previous presidential election. Once the necessary signatures are obtained, the proposed amendment is presented for a vote during the next general election, and if it receives a majority, it is incorporated into the constitution.

Alternatively, the Florida Legislature can propose amendments through a joint resolution, which, if approved by both legislative chambers and the Governor, is placed on the ballot for public voting in the general election.

The Florida Supreme Court also holds the power to amend the Constitution through its interpretations in legal cases.

The proposal comes at a point where several high-profile amendment initiatives are trudging forward at full speed. Florida voters will have a significant decision to make in the 2024 election as they face the opportunity to legalize recreational marijuana. A second push, led by abortion rights advocacy group Floridians Protecting Freedom, has reportedly gathered more than 1.4 million signatures, well beyond the required 891,523.

The proposed amendment seeks to establish the right to abortion in Florida up until the point of fetal viability — estimated at around 24 weeks. Current state law prohibits most abortions after 15 weeks of pregnancy and an expanded six-week abortion limit is being decided on by courts.