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House Math Doesn't Add Up: Fasano

Florida Current

State Rep. Mike Fasano of Pasco County went through the math of the House's health plan and showed how any family poor enough to qualify for it would be unable to afford it.

But then the House Select Committee on the Patient Protection and Affordable Care Act passed it anyway, with Republicans all voting yes and Democrats no.

Elsewhere at the Capitol, protests of the House plan were being held. One group led a sit-in at the office of House Speaker Will Weatherford, R-Wesley Chapel, until he agreed to meet with them, according to the Associated Press.

The plan, called Florida Health Choices Plus, would theoretically cover up to 115,700 adults who have minor children or are disabled and have incomes up to the federal poverty level.

The federal poverty level this year is about $11,500 for one person, $15,500 for two people and $19,500 for a family of three. (For exact dollar amounts, see this chart.)

As Health News Floridahas previously reported, the plan does not cover a majority of Florida's low-income uninsured, many of whom are either childless or middle-aged with no children under 18 still at home.

The plan would cost $237 million a year in state general-revenue funds, while turning down an average of over $5 billion a year in federal funds that would cover about 10 times as many people.

The plan was developed by Rep. Richard Corcoran, R-Land O'Lakes, who chairs the House PPACA Committee. But it was presented by Rep. Travis Cummings, R-Orange Park.

He did not answer the math questions that Fasano raised; no one else tried, either. Fasano had tried to amend the bill to substitute Sen. Joe Negron's Healthy Florida plan, which would take federal funds to cover more than 1 million uninsured low-income Floridians.

Fasano, from New Port Richey, and Negron, from Stuart, are both Republicans, but they are not in agreement with the Republican House leaders. Neither are Senate President Don Gaetz nor Gov. Rick Scott, who are also Republicans.

Supporters of the House plan had three themes during the debate:

1) They don't want to accept any federal money because the federal government is not to be trusted to keep its word on the funds it's offering because it is "dysfunctional," as Rep. Kathleen Passidomo, R-Naples, put it.

2) They want to put people into the Floirda Health Choices Plus marketplace as an experiment to see whether they can drive down medical costs. Because those enrolling would be so poor they would have to shop around and bargain for the best deals, which they could pay for out of a health savings account, health-care providers would have an incentive to lower their rates, the thinking goes. And if providers' rates went down, insurance costs would go down, supporters said.

The Health Choices marketplace, which Sen. Aaron Bean also supports as a vehicle for enrolling low-income people, was created by the Legislature five years ago. It's still getting off the ground; no one is yet enrolled.

3) Medicaid, the joint federal-state program for low-income people, is worse than no insurance at all, some said. The federal funds would come through an expansion of Medicaid under the Affordable Care Act, and thus is not acceptable.

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.