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‘Choices’ plan stalls at starting gate

By Christine Jordan Sexton

9/15/2009 © Health News Florida 

(Part 1 of 2)

Florida Health Choices, pushed as a solution to the state’s high rate of uninsured last year by Republican House leaders, still has no insurers or businesses signed up.

That makes it even less successful than the program created at the same time, Gov. Charlie Crist's "Cover Florida." At the end of July, Cover Florida had about 4,130 policies, while recent census data show the number of uninsured Floridians has grown to 3.6 million.

The results so far mean neither Crist nor Marco Rubio, his opponent in the Republican primary for U.S. Senate, can use the state’s efforts on the uninsured as campaign fodder. Rubio pushed the Health Choices plan as House Speaker.

State Sen. Dan Gelber, D-Miami Beach, had predicted the plans wouldn’t accomplish much and called them “cosmetic.”

“Florida has no meaningful response to the crisis of the uninsured, and we’re not even mentioning the under-insured,” Gelber says now.

Crist is partly to blame for delays on Health Choices because he was slow to make appointments to the board, says Chairman Aaron Bean, who sponsored the plan last year as House health council leader. Bean also faulted Sunshine Law requirements that require meetings to be advertised so the public can attend.

He remains hopeful that some health plan can be offered before the end of 2009. “Would I have preferred to have it already be up? Yes,” he said.

The idea was that Florida Health Choices would promise employers a free market where any package of care could be sold by approved providers, including chiropractors, dentists, and other non-traditional sources of insurance. The benefits would be paid for with pre-tax dollars.

But even when the marketplace is running there is no guarantee that insurers will want to participate, says Tallahassee attorney Bruce Platt, who represents health plans before the Office of Insurance Regulation. While they’d be free of the usual state-imposed “mandates” for minimum coverage, he said, the insurers still have to meet other requirements, such as an adequate network and sufficient finances.

Before Florida Health Choices can even worry about attracting insurers it needs a chief executive officer. Board member Becky Cherney of Orlando said a job posting this summer brought 39 applicants from ”all over the map.”

Cherney, president and chief executive officer of the Florida Health Care Coalition, is putting together an applicant matrix for the board to review at its Sept. 21 meeting in Orlando.

While Health Choices has had a slow start in Florida, it may play a role in the national reform plan being debated in Congress, Bean predicts. The bill that eventually emerges is expected to include an “exchange” that sets up the common rules regarding plans’ coverage and prices and helps explain them to the public.

“We could be big winners,” Bean said.

Conversely, if Congress changes the current tax incentives that allow for cafeteria-style health plans to be bought with pre-tax dollars, Bean’s project could be smothered in its cradle.

“We could be big losers," he said. "It’s a scary time right now.” 

--Christine Jordan Sexton is co-founder of