Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.

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— Marketplace Overhaul —

Rep. Taylor Yarkosky has filed legislation to overhaul and rename the Florida Health Choices Program, refocusing it as an employer-based health marketplace.

The measure (HB 141) renames the initiative as the Florida Employee Health Choices Program. It rewrites much of the existing statute governing how small businesses and workers can access private health coverage options. The program, originally envisioned as a health insurance “marketplace” when created in 2008, never reached full scale and was later criticized as redundant after the rollout of the federal Affordable Care Act.

Yarkosky’s bill reorients the program around individual coverage health reimbursement arrangements — a federal model allowing employers to contribute tax-free dollars to employees who then purchase their own health insurance plans. The proposed changes would authorize the creation of a centralized marketplace for participating employers and workers, streamline enrollment processes, and modernize vendor and product eligibility to reflect current insurance regulations.

Under the measure, the administering corporation would be renamed Florida Employee Health Choices, with an eight-member Board that includes appointments from the Governor, Senate President and House Speaker. The corporation would be tasked with establishing and managing a digital platform where employers can help workers purchase individualized coverage and related health services.

The bill removes provisions related to risk pooling and insurance code exemptions, shifting the focus from experimental market structures toward integrating employer and employee health purchasing. If enacted, the overhaul would take effect July 1, 2026.

— Nursing accountability —

Republican Rep. Toby Overdorf has refiled a proposal seeking to tighten oversight and raise accountability standards for Florida’s nursing education programs.

The new bill (HB 121) mirrors much of the language included in the 2025 legislation that was part of Senate President Ben Albritton’s “Rural Renaissance” initiative. The original measure passed with bipartisan support but was blocked in July after the Governor called it an example of “bureaucratic overreach.”

Overdorf’s refiled bill would require the Board of Nursing to impose stricter reporting, testing and remediation requirements for nursing programs and their directors. Among its provisions, the bill directs programs to identify struggling students early, provide tailored support, and administer a mandatory exit exam before graduation. Programs with poor National Council Licensure Examination (NCLEX) passage rates would face heightened scrutiny, probationary status or termination.

The legislation also empowers the Department of Health to conduct on-site evaluations and revoke a program’s approval in cases of persistent noncompliance. It expands the Florida Center for Nursing’s annual reporting duties to track the impact of exit exams and remediation efforts on student outcomes.

Supporters say the changes will help boost nursing education standards amid low statewide NCLEX passage rates and a continued shortage of health care professionals, particularly in rural communities. But the Governor, in his veto message, argued the measure “would deter programs from accepting students” and encourage an overemphasis on test prep instead of hands-on clinical training.

The bill would take effect July 1, 2026, if signed into law.

— Autonomy expansion —

Republican Sen. Keith Truenow of Tavares has refiled legislation aimed at expanding the scope of practice for advanced nurse practitioners in Florida by authorizing psychiatric nurses to work autonomously.

The measure (SB 138) amends state law to allow psychiatric mental health advanced practice registered nurses (APRNs) to provide mental health services without physician supervision, provided they meet criteria set by the Board of Nursing. Current law allows autonomous practice for APRNs in limited fields such as primary care, family medicine, general pediatrics and general internal medicine.

If approved, psychiatric nurses could evaluate, diagnose and treat patients independently and establish their own practices. Supporters say the change could help alleviate Florida’s shortage of mental health professionals and lower treatment costs, aligning the state with more than two dozen others that already grant such authority.

During the 2025 Session, a similar proposal cleared the House but failed to gain traction in the Senate. Opponents raised concerns about oversight and potential impacts on the quality of care, arguing the change could discourage students from pursuing psychiatry through traditional medical pathways.

Under the new bill, certified psychiatric APRNs would be able to admit, manage and discharge patients from health care facilities and perform many functions currently reserved for physicians. If enacted, the legislation would take effect July 1, 2026.

—ROSTER —

The Florida Senior Living Association (FSLA) has a new advocate in the Capitol.

Elaina Morgan has officially registered as a lobbyist for the association, taking on the title of Director of Medicaid and Regulatory Support.

Morgan brings more than seven years of experience in health and Medicaid policy to her new role. Before joining FSLA in July, she served as a Legislative Analyst for the Senate Committee on Health Policy, where she evaluated proposed legislation and provided policy guidance under Senate Presidents Kathleen Passidomo and Albritton.

Earlier, she spent nearly five years at the Agency for Health Care Administration, holding multiple posts within the Bureau of Medicaid Policy, including Government Analyst and Government Operations Consultant. Her portfolio there covered pharmacy and prescribed drug policy, behavioral health, and specialized health services.

— ICYMI —

“NCH planning 150-bed hospital in Ave Maria for eastern Collier” via Liz Freeman of Naples Daily News — Residents of Ave Maria and other communities in eastern Collier County are getting a lot of attention from NCH, which will include a freestanding emergency room and a new hospital. The nonprofit hospital system has developed a detailed plan to address the health care needs of the rapidly growing area of Ave Maria, as well as new developments in the planning stages in the broader region. Barron Collier Companies, Ave Maria’s developer of residential and commercial properties, has donated 18 acres to NCH in exchange for NCH meeting the medical needs of the area, which will ultimately include a 150-bed hospital. The location for the future hospital, targeted for a groundbreaking in 2032, is adjacent to the Arthrex manufacturing plant on the north side of Oil Well Road. Naples-based Arthrex manufactures medical devices.

“Democrats play the hits on health care. Why fewer people are listening.” via Nate Cohn of The New York Times — Health care once defined America’s political divide, but it’s now barely a blip on voters’ radar. Only one percent cited it as a top issue in the 2024 Election, and even the latest government shutdown revolves around it only incidentally. Democrats forced the standoff partly to spotlight expiring Obamacare subsidies and GOP cuts, hoping to rekindle an issue that used to play to their strengths. But Trump-era politics shifted the national focus to immigration, culture wars, and executive power. Republicans no longer campaign against health programs, and Democrats lack a bold new expansion to champion. With 92% of Americans insured and little appetite for sweeping reform, health care has faded as a defining political battleground — replaced by fights over identity and power.

“Bold moves for women’s health: How Baptist Health South Florida is transforming cancer care” via Florida Trend — Breast cancer doesn’t wait for the right time, and for young women, it often strikes amid careers, family plans, and future dreams. Baptist Health’s Young Women’s Breast Cancer Program meets these challenges with a comprehensive, compassionate approach that combines leading-edge medicine with personal support. Its multidisciplinary team — spanning oncology, fertility, genetics, and survivorship — helps patients navigate treatment while preserving their health, fertility, and emotional well-being. Through oncofertility counseling, mental health care, and peer connection opportunities, the program empowers women to face cancer without putting life on hold. By merging advanced science with empathy, Baptist Health ensures every woman has the strength, resources, and confidence to move forward — not just to survive, but to thrive.

 — RULES — 

The Agency for Health Care Administration’s final rule 59G-6.009, regarding training, education, and clinicals in health funding programs, goes into effect Oct. 26. More here.

The Board of Speech-Language Pathology and Audiology’s final rule 64B20-5.005, regarding requirements for renewal of provisional licenses, goes into effect Oct. 29. More here.

The Board of Respiratory Care’s final rule 64B32-6.004, regarding procedures for approval of attendance at continuing education courses, goes into effect Oct. 29. More here.

 — PENCIL IT IN — 

Oct. 22 

— Happy birthday to Senate President-designate Jim Boyd!