At a town hall this week hosted by Democratic U.S. Rep. Sheila Cherfilus-McCormick on “The Future of Medicaid, Medicare, and Social Security,” extending the tax credits for private health insurance was one of the topics of discussion.

“The enhanced premium tax credits provided by the Affordable Care Act are set to expire at the end of 2025,” read the moderator from a question submitted by someone in the audience. “These tax credits help millions of people here in Florida afford health care. Does Congress have a plan to extend these tax credits in order to keep health care affordable for these Floridians?”

Currently, more than 4 million working Floridians and their families receive tax credits that reduce the monthly premiums they pay for private health insurance.

If Congress fails to act this year and allows these tax credits to expire, premiums would skyrocket. A 60-year-old couple earning $82,000 a year would pay $13,000 more for their annual premiums.

“Making sure we preserve those tax credits to actually help families is our No. 1 priority,” Cherfilus-McCormick said.

Many, including families with small children, people with chronic conditions, early retirees and small-business owners, will simply not be able to afford coverage.

Floridians in rural areas are expected to be among the hardest hit if tax credits are not extended. Options in rural areas are fewer and harder to reach, and the cost of insurance is much higher.

While Cherfilus-McCormick hails from a blue district, an overwhelming majority of Republicans want to see the tax credits extended.

Trump pollster Tony Fabrizio found that 78% of Donald Trump supporters nationally want to see the health care premium tax credits for working families extended, according to exclusive reporting in the Washington Examiner.

Republicans have a razor-thin majority in Congress, 217-215, and extending the tax credits is especially important if they want to maintain that majority during the upcoming Midterms.

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Florida has built a unique and effective safety net system to ensure uninsured and underinsured individuals receive critical behavioral health services. After the Parkland tragedy, the Legislature also tasked our safety net with implementing crisis response teams to assist anyone in need within 59 minutes.

Behavioral Health Managing Entities, acting as a Lead Agency under contract with the Department of Children and Families, work with more than 300 local providers statewide to offer local services, ranging from crisis intervention to long-term recovery support. Florida’s behavioral health safety net system serves more than 250,000 individuals annually.

These lead agencies operate as not-for-profits and provide the highest return on investment, with an administrative rate below 3.2%. This efficiency ensures that every taxpayer dollar is used effectively, with fiscal prudence and transparency.

Recently, Florida lawmakers introduced House Bill 633 and Senate Bill 1354, requiring the Department of Children and Families to subcontract operational and financial audits to evaluate which metrics and criteria best assess performance and outcomes. The bill would also standardize data requirements and reporting, increasing transparency for all stakeholders.

As CEO of Florida’s Association of Managing Entities, I can confidently affirm that our commitment to accountability and transparency is unwavering. Each Behavioral Health Managing Entity submits more than 65 reports annually to the Department of Children and Families, detailing business practices, contracting requirements, performance outcomes, and expenditures.

We commend Representative Koster and Senator Trumbull for their leadership and commitment to developing the behavioral health performance management system of the future.

Beyond financial accountability, Florida’s Behavioral Health Managing Entities focus on evidence-based best practices to maximize positive outcomes. In Fiscal Year 2023-2024, our network of providers achieved the following results:

• 98% of children in the Community Action Treatment (CAT) Teams were diverted from juvenile justice system involvement.
• 97% of children in the CAT program avoided placement in State Inpatient Psychiatric Programs.
• 96% of individuals enrolled in payor-level care coordination avoided costly crisis stabilization units, emergency rooms, and jails.
• Through Mobile Response Teams, 80% of individuals were diverted from Baker Act admissions, resulting in an estimated annual cost savings of $12.2 million for the state.

Behavioral Health Managing Entities are just one part of Florida’s vast and complex behavioral health system. Transparency and accountability must be extended to the entire behavioral health system of care, including private insurance and Florida’s Statewide Medicaid Managed Care Program, overseen by the Agency for Health Care Administration.

Behavioral Health Managing Entities and their network of providers are the safety net that cares for the state’s most vulnerable populations. We are dedicated to serving Floridians with complete transparency and accountability in the best way possible. We meet each community’s unique needs and help Floridians get back on their feet to live life to their fullest potential.

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Natalie Kelly is CEO of the Florida Association of Managing Entities.

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