As the Senate began moving forward Thursday with a plan to offer health insurance to hundreds of thousands of low-income Floridians, it faces House resistance to relying on federal money to pay for the program, reports Jim Saunders of the News Service of Florida.
Rep. Richard Corcoran, a Land O’ Lakes Republican who is chairman of a House select committee studying the federal Affordable Care Act, said many concepts of the Senate plan are “easily bridgeable” with House ideas about helping people get health coverage. But he said the House does not agree with the Senate plan’s use of federal funds.
“The biggest difference is certainly funding,” Corcoran said.
Republicans in both chambers this month rejected a major expansion of the Medicaid program under the Affordable Care Act, but they have said they want to find other ways to help offer coverage.
The Senate Appropriations Committee took the first formal step Thursday when it introduced a bill that would create a program called Healthy Florida, which would use a longstanding state program — the Florida Healthy Kids Corp. — as a vehicle to offer private health insurance. The program would target the same group of people who would otherwise be eligible for the Medicaid expansion and would rely heavily on federal money to pay for the coverage.
The plan, which Appropriations Chairman Joe Negron first outlined last week, has quickly received backing from groups ranging from the hospital and managed-care industries to the left-leaning Florida Center for Fiscal and Economic Policy. Also, Gov. Rick Scott has expressed support.
Negron, R-Stuart, has tried to draw a distinction between the Healthy Florida bill and expanding Medicaid, describing his plan as “premium assistance for people who go to work every day.”
“We’re not putting one more citizen of Florida into the current Medicaid program,” he said.
The issue is tricky for many Republicans, however, because they spent more than three years fighting the federal Affordable Care Act, better known as Obamacare. House Speaker Will Weatherford, R-Wesley Chapel, has repeatedly expressed skepticism about accepting billions of dollars in federal money to pay for expanding Medicaid — money that effectively would be used to pay for Healthy Florida.
But Sen. Andy Gardiner, R-Orlando, said he thinks a “gap” in people having health coverage will develop as the Affordable Care Act fully takes effect next year. While many people will continue to receive Medicaid coverage and others will face penalties if they don’t buy private insurance, some people would fall into the gap and remain uninsured, he said.
“What do we do as a state?” he asked. “Do we just throw our hands up and say, well we’re not going to accept any federal dollars?”
The Healthy Florida plan would be offered to people whose incomes are up to 138 percent of the federal poverty level, a move that likely would have its greatest impact on childless adults who are largely shut out of Medicaid. People would choose among private health insurance plans and make at least small co-payments when they visit doctors or hospitals.
The federal government would have to approve the Healthy Florida plan before it could take effect. Negron said people could start signing up Oct. 1, with coverage possibly beginning Jan. 1, 2014.
But the more-immediate issue is whether the House and Senate can agree on Healthy Florida — or some other type of plan. Corcoran said he is working on a proposal but that it would probably rely on state money, not the federal funds.
Also, Corcoran indicated the House likely would target people who are below 100 percent of the federal poverty level, which for a family of two is $15,510, according to federal numbers. People with higher incomes than that could get subsidized coverage through a health-insurance exchange, a type of online insurance marketplace created by the Affordable Care Act. Florida is not involved in running the exchange.
Corcoran said the House and the Senate share the concept of offering private-market options to people. He said that could involve using Florida Healthy Kids or a long-planned program, Florida Health Choices, which is expected to serve as another type of online health marketplace.
It remains unclear, however, when the House might present a detailed proposal.
“Our goal is ASAP, as soon as possible,” Corcoran said. “But there’s not a date.”