Hillsborough Health Plan Expands Eligibility, Benefits

A health plan that provides care to low-income Hillsborough County residents is expanding to serve more people.

The changes, approved by Hillsborough County commissioners, will increase the income level for eligibility, provide vision benefits and do away with a rule that disqualified residents who had three felony convictions.  

The improvements will add about 2,200 people to the Hillsborough County Health Care Plan, which last year covered nearly 20,000 people.  All of the costs are covered by a half-cent sales tax, approved by voters before the plan began more than 25 years ago.

“When you can expand both coverage and the services we offer and eliminate a punitive policy that really wasn’t helping the community, that’s just a terrific success story for this plan and it’s why we are the envy of so many communities around the country,” said Donna Petersen, a senior vice president at USF Health and a member of the plan’s advisory board.

The county adopted the three-strike policy, which kept felon voters off the plan, in 2005. This year, it conducted a study to see what the effect would be if the policy were removed.

About 450 people per year were denied coverage due to the policy.

The analysis found that between 70 and 80 percent of the felony convictions were for drug related offenses. 

“The number that we were denying because of this was heartbreaking,” Petersen said. “And then when we broke it down and realized that a lot of the convictions were related to behavioral health, substance abuse -- things that we should be treating and not punishing.”

The analysis also found that the county could save $1.8 million by eliminating the policy because those who are denied coverage end up in emergency rooms where the cost of care is more expensive.

“Over time, you say, well is that really in our collective best interest to deny people health care which might help them be more productive and feel better and have a higher quality of life?” Petersen said.

The decision to increase the income level for eligibility will help the county cover more of the working poor who make too much to qualify for Medicaid but not enough to qualify for Affordable Care Act subsidies, she said.

When the Affordable Care Act was established, it expanded Medicaid to cover people who earned up to 138 percent of the poverty level. Those who earned more, were eligible for subsidies through Affordable Care Act plans.

But Florida legislators chose not to expand Medicaid, creating a coverage gap for people who earned between 125 percent and 138 percent of the poverty level.

Changes to the Hillsborough health plan will assure that people who fall in that gap are covered.

“Raising the eligibility up is important because it really helps us get at the original target of this plan, which is the working poor,” Petersen said. “Every time we enroll someone on this plan and get their health care needs met it helps all of us because it creates people who are healthier, not needing high-cost health care, more able to be productive, all of those things that are good for the community.”

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