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Plan to Extend Health Insurance to 800,000 Poor Floridians Crawls Against Steep Hurdles

| March 16, 2015

Sen. David Simmons is among the lawmakers looking for a way to 'take down' $52 billion in federal dollars that he says 'belong' to Florida, but only if the state expands access to health insurance for the poor. (Facebook)

Sen. David Simmons is among the lawmakers looking for a way to ‘take down’ $52 billion in federal dollars that he says ‘belong’ to Florida, but only if the state expands access to health insurance for the poor. (Facebook)

A plan to provide health care coverage to 800,000 Floridians faces an uphill battle after unanimous approval by the Senate Health Policy Committee.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said Wednesday that the Senate plan includes requirements that federal health officials at the U.S. Centers for Medicare and Medicaid Services (CMS) may not support.

She said SB 7044 requires people to pay monthly premiums ranging from $3 to $25, depending on whether they’re below or above the poverty line. That’s very different from other Medicaid expansion alternatives other states have had approved by the Centers for Medicare and Medicaid Services.

“The bill does include premiums for everyone starting at zero percent of the poverty line. As we’ve learned from Indiana, Iowa and Michigan, CMS has not been willing to approve enforceable premiums below poverty and for good reason- they’re a clear barrier to coverage,” she said.

“But they (CMS) have been willing to approve very complicated cost-sharing arrangements which are different in each of those three states I mentioned and they do involve people paying monthly costs all the way down to the poverty line.”

The Senate plan proposes using a state-wide private insurance marketplace for these low-income Floridians, using the existing Florida Health Choices exchange.

The new Florida Health Insurance Affordability Exchange Program, or FHIX, would assist Floridians not eligible for Medicaid in purchasing health benefits coverage and gaining access to health services, according to the bill.

During a press conference in Tallahassee last week, Senator David Simmons, the Maitland Republican, said making way for the new system is just the beginning.

“We already are taking Medicaid moneys, a lot, billions and billions of Medicaid dollars. I would like to reform that system as well,” Simmons said. “I think this is a wonderful opportunity for us to go ahead and treat this almost like a pilot project. To get this done, certainly take down the $52 billion that belongs to Floridians and at the same time provide a model-a model that we can use that is a free enterprise, free market based model for the rest of healthcare in the state of Florida.”

It’s similar to the Arkanasas state health exchange, which has been approved by CMS, Alker said.

“Purchasing coverage through this type of exchange is a new twist on an Arkansas-style approach,” Alker said.

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Also, a work mandate under the proposed plan would require participants to work 30 hours a week if they don’t have children, and 20 hours a week for parents of children under 18. Unemployed adults could qualify by spending that time searching for employment, participating in job-training or placement activities or pursuing their education.

Disabled adults and their caregivers could file for an exemption.

Veteran watchers of the Medicaid expansion debate know this work-requirement issue arose in Pennsylvania, where the governor included a similar request in his original proposal. By the end of negotiations, it was removed.

Utah’s governor was also negotiating on this issue with the federal government.

“Conditioning eligibility on work or job training requirements is not going to pass muster, but thinking through linkages to job training resources and program and perhaps, in a new twist, educational opportunities, may very well be an area CMS is willing to negotiate on,” Alker said.

Whether CMS even gets the chance to negotiate and sign off on the bill is uncertain. It first faces more committees and needs approval by the Florida House, which has shut down similar bills the past two years.

–Daylina Miller, Health News Florida

16 Responses for “Plan to Extend Health Insurance to 800,000 Poor Floridians Crawls Against Steep Hurdles”

  1. KB63 says:

    Well, it’s a step in the right direction but again the powers that be are out of touch with the reality of low income & middle class. From what I have seen, part time employees generally get 27 hours per week and are really lucky to get 30. And they need a “flexible schedule” so it makes it nearly impossible to get a second job & keep both employers happy. And to tell parents with children they must work 20 hours a week to be eligible? Go to work for $8 -$9 an hour, pay for child care, have a car, insurance, pay for gas, extras for work clothes, lunches. Might as well stay home. Wish these politicians were all made to live for 3 months with the struggles and brick walls an average person faces, perhaps then some things would change for the better.

  2. confidential says:

    Is always the wealthy or the GOP politicians who we are all supposed to sustain on lavish health care plans of the taxes we pay that really oppress the lower middle class and poor demanding up front impossible to fulfill requirements. What a lack of compassion with their own fellow country men, women and children, when in the other hand roll the red carpet for the head of one so called allied that count among its peers the wealthiest individuals in this wide world but come here extending their hand and asking for us giving more lives yet and the funds we can’t afford to fight their wars.

  3. Vincent says:

    I have had no health coverage for fourteen years while living in Flagler County. For a long while I could not even purchase a policy due to pre existing conditions. Purchasing a policy now would be cost prohibitive. In order for a single person with no kids to receive medicaid they must prove 100% disability. Most claims are denied. Law firms have popped up across Florida handling nothing but these cases. It is very hard to understand what it is like to have no health coverage until an individual experiences it. I doubt those that are opposed have the empathy to know the difference. My background is that I graduated with high honors from two Florida universities, worked as a professional jeweler, and am now one of the 800,000 that have no coverage. One of the arguments is well you must be lazy and do not want to work. I earned a 2nd Degree Black Belt in the past so I am not lazy. I worked hard while my conditions got worse and it seems like noone cared. My voice asked for help over and over until I had no voice left.

    • Aves says:

      Vincent, I’m sorry you’re unconvered. i really hope FL does the right thing and money will happen so you can be covered soon.

  4. ted bundy says:

    we need all floridians to have health the right thing and accept the money, no strings!!!!

  5. Lancer says:

    …yep, we need more government in healthcare. It hasn’t worked for over 100 years…since the 1906 federal food and drug act through medicare in 1965 to the 1973 hmo act through to the 2004 prescription drug plan to 2010’s ACA…but, I guess the provoking thought is that “we’ll make it work THIS time!”


    • Vincent says:

      I would like to see where America would be if not for the passage of laws and programs. The VA, Medicare, and Medicaid are government run health care programs. How much do current government programs contribute to the economy? I even know doctors that are against government healthcare but their not against receiving hundreds of thousands of dollars from medicare. Ponder if you would where retirement plans, pensions, 401K’s, and stocks would be if we take all the money out of the economy from government programs. I wonder what the unemployment rate would be then. If anyone is against programs like medicare then they can choose not to use it and pay cash. Lawmakers that are so against government programs should not use the benefits the government provides them. My point is that most people are receiving benefits either directly or indirectly from the government yet they are against the very hand that is feeding them. I have heard arguments from people who will say they did it all on their own. How is that possible if along the way you received a benefit that our country provided you?

  6. Lancer says:

    We have over 100 entitlement programs, we have spent trillions and have not lowered the poverty rate a single percentage point in over 50 years. That is failure only a leftist can ignore. You called them “safety nets”. I look at the very high recidivism rates of these programs and see that they are dependent ways of life. People have lost hope and are becoming embittered.

    Social Security is a massive, mandatory Ponzi scheme, there is no lock box(I make far more on my personal retirement accounts, even with the recession than the return on SS). Medicare is rampant with inefficiency. They set minimums in a free market…a bonafide economic no-no. The VA was supposedly scourged of its inept leadership and mismanagement, but we found that they were firing anyone who spoke the truth! The rampant, waste fraud and abuse of our food stamp program. Why aren’t our veterans able to go to ANY doctor…why do we even need special government hospitals that struggle to provide our veterans with quality of care? Ridiculous.

    Your entire premise is the “Broken Window Fallacy” and isn’t based on reason and logic, it is based on emotion. Government cronies have always used the “we have to do something!” excuse to expand into our lives. For example, our completely bogus progressive income tax was sold as a temporary measure to fund WWII.Nearly 70 years later the government still gets its hands on personal property before the person who earned it does! Social Security was passed long before the many financial products for retirement we have now. Everyone knows the SS numbers don’t add up, man.

    The question is NOT…”where would we be without government?”

    The statement is: Look how far we’ve come in spite of government!

    When you effectively have 47% of the US population not paying federal income taxes…that is a problem. When you’re not instituting policies that increase GDP by 3.5%, minimum per year and grow government (that cannot do anything without first taking funds from someone who earned it in our economy)…that is a problem.

    Surely, you aren’t foolish enough to actually think that the Federal government doesn’t waste taxpayer dollars, right?? Yes, I know everyone has an emotional attachment and dependency on government goodies…that is not a good thing. Because there is something called: The Law on Unintended Consequences. This Law destroys all things do-gooder for common sense reasons.

    Are you aware of the Unfunded Liabilities of the Federal Government due to all these programs? While life is just dandy for baby boomers…we still need to have a country left after their policy debacles have destroyed any semblance of success for their kids, grand kids and great grand kids.

    Here’s a few of the low lights regarding the Fed’s 2014 financial status:

    ◾Washington spent nearly $3.5 trillion in 2014 while collecting nearly $3 trillion in revenues, resulting in a deficit of slightly less than half a trillion. In other words, 14 cents of every dollar that Washington spent in 2014 was borrowed.
    ◾Over the past 20 years, federal spending grew 63 percent faster than inflation.
    ◾Mandatory spending, including Social Security and means-tested entitlements, doubled after adjusting for inflation.
    ◾Discretionary spending grew by 47 percent in real terms.
    ◾Despite publicly held debt surging to three-fourths the size of the economy (as measured by GDP), net interest costs have fallen as interest rates have dropped to historic lows.
    ◾Three major budget categories—major health care programs, Social Security, and interest on the debt—will account for 85 percent of nominal spending growth over the next decade. Entitlement reform is a must to curb the growth in spending.

    I understand Balance Sheets. Try looking objectively at our country’s financial situation…those are not good numbers and good times on other people’s dimes only last til the pockets are empty.

    We would all be much better off, if the government started reducing its size and scope. We would be better off if the government would do an audit of itself, cut spending where necessary and promoted and passed policies that would stimulate the economy and grow individual wealth.

    …but, people with money don’t depend on government as much…and government cronies need that dependency to stay in power.

    • Obama 2015 says:

      Republicans take advantage of entitlement programs and this country is doing just fine. Stop all the doom and gloom. The dollar is stronger than it has been in 25 years, oil prices are under $3.00 and we are adding jobs to the economy. We have 16 million people paying for insurance via the ACA.

      But to pick apart your points.


      In 2013, the official poverty rate was 14.5 percent, down from 15.0 percent in 2012. This was the first decrease in the poverty rate since 2006.

      SS is never going go away. With them collecting more than they pay out, collecting interest it will never fail. This has been proven over and over and over again. In fact if everyone stopped paying they have enough til about 2033!

      47% of the US population not paying federal income taxes

      From Forbes

      The vast majority of non-income taxpayers fall into three categories:

      17 percent includes students, people with disabilities or illnesses, the long-term unemployed, and other people with very low taxable incomes. Also included would be people like our soldiers in foreign wars who are exempted from paying income taxes while they are on active duty in a war zone.

      22 percent of people who did not pay federal income taxes in 2009 are people aged 65 or older who have modest incomes (and do not have earnings).

      61 percent are working people who pay payroll taxes but are not paying income taxes. These are
      Americans who work, earn an income and are, nevertheless, exempted from paying the income taxes the rest of us are required to pay. Keep in mind that we are talking about roughly 30% of the population when we consider those in this category.

      **How do you expect these people to pay income taxes when the law states they don’t qualify. Do you want to change the IRS laws to take more money from people with no money?

      Washington spent nearly $3.5 trillion in 2014 while collecting nearly $3 trillion in revenues, resulting in a deficit of slightly less than half a trillion. In other words, 14 cents of every dollar that Washington spent in 2014 was borrowed.

      Remove the Bush tax cuts and this goes away. That is how Clinton balanced the budget. Just make the tax laws back to how Reagan Bush I and Clinton had it and that would go away.

      I value your opinion but you’re using Talking points not facts.

      • Lancer says:

        “Clinton balanced the budget”????

        1. Payroll taxes are NOT federal income taxes. Of course, knowing this makes you a dishonest socialist….no surprise there. Thank you for proving my point.

        2. “Clinton balanced the budget”??? Thank you for showing a complete and fundamental ignorance of our government. Congress controls the purse strings, 0bam-bam. Last time I lived through that time…Republicans, under a thing called “The Contract with America” balanced the budget when democrats lost control of the house and senate.

        You cheer because government showed only a 1/2 TRILLION dollar deficit! Such is you love and belief in government…it is no wonder that you don’t give them everything and allow yourself to be solely at their mercy.

        Pardon me if I don’t bow to my knees and subjugate myself…

  7. Vincent says:

    America is a great country because people are free to voice their opinions. In the most recent presidential elections the majority showed that they do not share your opinion. In order for the right wing republican agenda to be realized they will have to win a presidential election. We can then reform or end all entitlements and see how the country does. If people feel they are better off getting nothing from the government as far as entitlements then you can keep the white house under republican control indefinitely. We can then compare the GDP under the right wing philosophy to what we have now. When more companies fail, unemployment increases to historic levels, deflation takes hold, pension funds crumble and we enter a historic depression the American people will decide if they have made the right choice. The majority of our GDP is consumer driven and when the consumer has less money then they consume less . The very reason we can debate is because our government decided to pour massive resources into defeating Germany and Japan during WWII. How do you plan on replacing the consumption generated by government programs.? Show me a country that is in a better financial situation than the USA. If you think we have come this far in spite of the government keep in mind that our military represents our government. We live in a very interconnected system so their is great interdendence. The claim that 47% do not pay taxes is not true and does not tell the whole story. They may not pay income tax because their income is to low which benefits corporations which in turn benefits walstreet. The net efftect of the 47% working for little money is higher corporate profits which generate more income taxes collected. The 47% also pay sales tax and contribute to our economy. My argument to you is that you have to understand how the system works before you can properly make adjustments to something so complex. It is important that people look deeply into a matter. It is simple and easy to believe anything.

  8. Sherry Epley says:

    Thanks Obama 2015 and Vincent says . . . couldn’t have said it better myself. It’s always good to hear reasonable logic and facts contrary to “FOX talking points”.

    I’m just wondering why those who are so against government in the USA live here.

  9. bob says:

    horrible where in but america if you have no health care you are fined again the middle
    income earners are shafted with our ungodly people running this country 1600 pages
    of this unconstiutional health care the average person knew nothing about. i said
    it before our rights are being taken away america is becoming a third world country
    illegals get free care muslims get free care women in there teens having children
    out of wedlock free that is obamas way of destroying america.proverbs 14-34
    righteousness exalts a nation but sin is a reproach to any people.

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