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For Florida’s Poorest 600,000, a Stingy Health Care Proposal that Cuts to the Bone

| April 1, 2013

Sen. Aaron Bean is proposing a cosmetic version of health care for the poorest.

Sen. Aaron Bean is proposing a cosmetic version of health care for the poorest.

In a possible alternative to expanding Medicaid, a Senate committee Tuesday is expected to take up a proposal aimed at helping low-income Floridians get health services — while turning down billions of dollars in federal money.

The proposal, which Senate Health Policy Chairman Aaron Bean has helped draw up, would create the “Health Choice Plus Program” and would target adults whose incomes are below 100 percent of the federal poverty level.

Health Choice Plus would not be a traditional health-insurance program. Instead, money would go into accounts, which enrollees could tap to help pay for health-care services.

The proposal (SPB 7144) comes after House and Senate Republicans rejected an expansion of the Medicaid program under the federal Affordable Care Act. But it also differs greatly from a proposal by Senate Appropriations Chairman Joe Negron, R-Stuart, to use federal money to provide private insurance coverage to hundreds of thousands of low-income Floridians.

Bean, R-Fernandina Beach, has discussed his idea in broad terms, but the bill posted online provides the first clear details. During a March 20 meeting, Bean said he was trying to find a way to address health care for about 600,000 uninsured Floridians whose incomes fall below the poverty threshold, without becoming “addicted” to federal money.

Under the new bill, Health Choice Plus would be administered by the Florida Health Choices program, a long-planned — and long-delayed — state health marketplace aimed at small businesses. Bean is a former chairman of Florida Health Choices.

“What can we say yes to (as a way to) expand coverage for those without creating an entitlement?” said Bean, whose committee is scheduled to consider the bill Tuesday.

While House Republican leaders have not offered an alternative to expanding Medicaid, the general thrust of Bean’s proposal addresses at least some of their concerns. Speaker Will Weatherford, R-Wesley Chapel, has made clear he doesn’t want to rely on federal money. Also, Rep. Richard Corcoran, a Land O’ Lakes Republican who is chairman of a select committee on the Affordable Care Act, has expressed interest in finding a way to help people below 100 percent of the federal poverty level.

But Health Choice Plus appears unlikely to satisfy Democratic lawmakers and groups such as the hospital industry that have lobbied heavily for Medicaid expansion or, more recently, have warmed to Negron’s proposal for private insurance coverage.

The Affordable Care Act, better known as Obamacare, seeks to offer Medicaid coverage to people whose incomes are up to 138 percent of the federal poverty level. In Florida, for example, that would open Medicaid coverage to many childless adults who are currently ineligible for the program.

Bean’s proposal would rely on another part of the Affordable Care Act as a way for people between 100 percent and 138 percent of the poverty level to get coverage. Those people will be eligible to get federally subsidized insurance through what is known as a health-insurance exchange, a type of online marketplace where they can shop for coverage.

But residents below 100 percent of the poverty level are not eligible for exchanges. For a one-person household, 100 percent of the federal poverty level equates to an income of $11,490; for a three-person household, it equates to $19,530, according to federal data.

The crux of Health Choice Plus would be to create “health benefits accounts,” which would receive money from enrollees, the state and possibly sources such as employers. Money in the accounts could be used for a wide range of expenses, such as physicians’ fees, prescriptions, co-payments and limited-benefit health plans.

Enrollees would contribute at least $20 a month to the accounts and also face other requirements, according to the bill. Those requirements include having health assessments within three months of enrolling, having at least one preventive-care visit to a primary-care provider within six months and working at least 20 hours a week or seeking employment — though the employment requirements would have some exceptions.

The proposal encourages the use of county health departments and federally qualified health centers as avenues for people to get care. Enrollees also might be able to receive extra money in their health-benefit accounts by taking steps such as getting dental exams and teeth cleanings, maintaining cholesterol and blood pressure at certain levels and having mammograms and prostate exams.

“Many insurance options are not affordable, and the Legislature intends to provide a benefit program to those individuals who seek assistance with coverage and who assume individual responsibility for their own health-care needs,” the bill says.

The bill does not specify how much money the state might spend on the program, though it indicates the state contribution to health-benefit accounts each month would not exceed $10 per person. Also, it says enrollment would cease when the program is full based on available funding.

The advocacy group Florida CHAIN, which has been an outspoken supporter of expanding Medicaid, quickly took issue with the new proposal Sunday, posting a message on Twitter that said the bill — “unlike Sen. Negron’s real alternative to Medicaid expansion — would spend max $10/mo from state and get $0 from feds.”

–Jim Saunders, News Service of Florida

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9 Responses for “For Florida’s Poorest 600,000, a Stingy Health Care Proposal that Cuts to the Bone”

  1. Nancy N. says:

    Just more proof that the Republican party hates poor people. The whole point of the Affordable Care Act was to provide health insurance for EVERYONE…and yet the Republican party in Florida is working overtime to give the shaft to our state’s most vulnerable citizens and lock them out of the law’s benefits.

  2. says:

    florida only wants people here with an already acquired pension and medical plan, salaries are horrendous here and the state is not an employer to employee friendly state. face it most of the money comes from outside the state. my wife has a masters in nursing and when the other nurses were talking to her about pay rasies they told here that the higher ups said we give you the sunshine and the ocean what more do want. will be leaving soon for texas where nurses receive a very generous salary especially highly educated ones this has been confirmed already.

  3. Sherry Epley says:

    Right on Nancy! Our genius state legislators don’t get it. If they don’t take the federal tax money, the money will not be refunded to the tax payers or lower the deficit. Again, Florida is a big JOKE! Comments on the news stations are that some other state will benefit. Talk about taking that “second amendment” gun and shooting yourself in the foot! A shining example of the Darwin theory!

    Before anyone starts . . . I am a true Florida native. My ancestors came to this region of the USA in the 1600’s. But that doesn’t mean I can’t think for myself and comment when our legislators are not acting in our best interest. Many of them simply do not care about their constituents because their decisions have been “bought and paid for” by those lining their pockets with huge “campaign contributions” AKA legal BRIBES.

    Unfortunately, the voters have less and less influence. . . it’s becoming more and more about money.

  4. Mel Bronson says:

    U.S. sees highest poverty spike since the 1960s, leaving 50 million Americans poor as government cuts billions in spending… Over 50 million Americans on food stamps. This is what the obama presidency has brought to America. Economic collapse, moral decay and starvation.

    You elect an ignorant progressive liveral street organizer who is hopeless and clueless and this is how America goes down the toilet. Will the parasites of America who are now dependent on government handouts ever learn the next time they vote????

  5. Legally says:

    Democrats prey on the poor. They create them, put them on the government teet, then constantly remind them that they are victims and they are entitled. We can see what their ideologies have done for the black man with over 60% of them incarcerated. We can see what their thug policies of strong arming banks into giving these people loans they can’t afford to pay back has done for the entire planet financially. Keep it up. Keep these people on the government teet and pretty soon there will be no one left to pay for them. Then what??

    • Nancy N. says:

      Boy you really live in a warped world.

      It was Republican deregulation of banks that allowed the sub-prime lending collapse to occur. And it’s not the Democrats that are incarcerating black men (60% is way too high, btw – it’s more like one in four), it’s Republican “tough on crime” laws and a justice system that disproportionately targets and penalizes minorities. Like laws that provide harsh penalties for crack, traditionally a drug used by blacks, and lighter penalties for the powder cocaine version of the same drug, traditionally used by whites.

  6. Seadog says:

    More of the Republican Social Darwism, dont get sick,, die quick attitude and dont bother us while your doing it.

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