Florida Considers Partners for Health Insurance Exchange

By | February 6, 2013

Florida lawmakers heard this week from two organizations that could serve as partners in running an insurance exchange under the federal health overhaul.

Florida has missed the deadline to run its own online marketplace where people can shop for health coverage, but lawmakers are considering whether they want to run their own in the future or partner with federal health officials. During a meeting in Tallahassee on Monday, lawmakers explored options from organizations already running programs similar to federal exchanges that they could partner with instead of building something new.

Florida Healthy Kids Corp. coordinates coverage for roughly 300,000 children and is responsible for selecting plans, collecting about $31 million a month in premiums and determining eligibility. Those are some of the main functions of the online exchanges.

The organization deals with individual coverage, while the exchange will also have to offer insurance plans to small businesses, but Executive Director Rich Robleto said they are essentially running the main operations required by the exchange now.

Florida has about 475,000 uninsured children. It’s difficult to estimate how many would qualify if the state expanded its Medicaid program under the Affordable Care Act. A third of those children are already eligible for Medicaid, but are not enrolled, said Robleto.

He estimated between 75,000 and 100,000 children would come into the CHIP program and about that same number would be eligible for commercial coverage.

Lawmakers also questioned whether there was a role for Florida Health Choices in the federal health overhaul. The program is essentially an online marketplace where small businesses can browse different health plans. Individuals should be able to shop the site this summer.

But the federally mandated exchanges will also tell shoppers whether they are eligible for federal health subsidies to pay for the insurance.

“Are you concerned you’re going to get pre-empted by the federal exchange because you don’t offer the subsidy?” asked Republican Sen. Joe Negron.

“It does make no sense for us to compete against a subsidized offering,” said Rose Naff, CEO of Florida Health Choices. She said the organization will likely need to shift its presence in the market.

South Florida Democratic Sen. Elaine Schwartz also complained that Florida Health Choices was started in 2008 and still isn’t operational five years later.

Naff said the website is slated to be up and running at the end of the month.

Lawmakers questioned whether the two organizations could work together with the state on some type of exchange going forward.

“If we made a decision soon we could certainly be open for an open enrollment period next October,” said Robleto.

But lawmakers still have some major decisions to make about so-called Obamacare’ first.

“I’m still searching and struggling to find an answer as to why the state would want to operate its own exchange. The rules are changing…it’s scary to put up that much state resources without knowing the full implementation and implication of what is going to happen,” said Republican Sen. Aaron Bean.

Currently federal health officials have indicated that all insurers who qualify and want to sell under the exchange are welcome.

But states could limit it to a smaller number of plans, set their own accreditation rules and quality standards, said Brian Webb, a manager with the National Association of Insurance Commission, who also addressed the committee.

“I see it as very limited as what states can do,” Bean said.

Topics Florida Mergers & Acquisitions Legislation

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