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Could FL Build Exchange from These 2 Groups?

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Two quite different programs that help Floridians find health insurance may end up competing to become the Florida face of the federal health-insurance exchange of the future. One or both would almost certainly not survive -- that is, unless they join forces.

The directors of Florida Healthy Kids Corp. and Florida Health Choices answered a barrage of questions Monday at a hearing on the Patient Protection and Affordable Care Act that drew committee members from both House and Senate. Both said they are aware they will need to find a way to work within the new law or become irrelevant.

The Select Committees on the PPACA are to come up with recommendations on how Florida should implement the law, and Monday's hearing was devoted to questions about an online shopping site where uninsured individuals and small businesses can find affordable coverage.

Such a site needs to be ready by Oct. 1 of this year so that shopping can begin for coverage that takes effect Jan. 1. 

Rich Robleto, executive director of Florida Healthy Kids Corp., said his group has been going strong for 22 years and has 300,000 children enrolled in health plans. Many of them are in families of modest means but with incomes above the level that currently qualifies for Medicaid in Florida, and they can receive subsidies for the children's coverage. Federal funds come through the Children's Health Insurance Program, or CHIP. Robleto said Healthy Kids has a large call center to answer questions.

An alternative for lawmakers to consider is Florida Health Choices, a still-in-the-works online marketplace for small employers that is now in the test phase, with a launch planned for next month. Director Rose Naff conceded that the Choices group will be pre-empted by whatever health insurance shopping platform the federal government may set up for uninsured individuals and small businesses to use.

Naff said her online marketplace could not hope to compete with a federal version because the latter will offer tax credits for small businesses and subsidies for individuals and families up to 400 percent of the poverty level. Her shopping site, which was passed by the Legislature in 2008 with $1.5 million, is intended to be self-sustaining, with a 2.5% surcharge for participating vendors, about 1 percentage point below the fee for insurers on the federal exchange.

The deadline for states to apply to run their own health insurance exchange was Dec. 14, 2012. To become a "partner" of the federal exchange -- to help set the rules -- states must apply by Feb. 15.

However, even if the state misses that deadline, it can apply for a federal grant to build its own exchange for next year. That appears to be the only possibility at this point, since Florida deliberately chose not to plan for its own exchange under past legislative leaders.

 Lawmakers at the hearing asked whether it would be possible to build an exchange this year if the two organizations worked together. Robleto said he and Naff have talked about combining forces, but in any event,  there is  no way they could get something ready in time for this Oct. 1, when the shopping for 2014 is set to begin. “That horse has left the barn,” Naff said.

For more details, see coverage by the Associated Press.  Information on both programs and more testimony at the hearing is available in this meeting packet.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.