What kind of health coverage can you buy for $20 to $30 a month?
"You can't," says John Sinibaldi, an independent broker in Seminole.
That may sum up the real-world prospects for Florida Health Choices Plus, the plan for extremely low-income uninsured Florida adults that State Sen. Aaron Bean's Health Policy Committee approved Tuesday along party lines.
Bean said he offered it in the knowledge that it wasn't much, but was at least something that the Florida House leadership might accept.
“Our challenge, senators, if we are going to move on something it has to be something that we can all say yes to,” Bean said. “The Senate, the House and our governor, we all have to say yes in order to move forward.”
Consumer advocacy groups aren't saying "yes," though.
The bill, SPB 7144, "would not remotely provide health coverage of any kind," said Greg Mellowe, policy director for Florida CHAIN. "Quite frankly, many drug store chains have coupons in the Sunday paper that would accomplish more than this."
Richard Polangin, government affairs director for Florida Alliance for Retired Americans, offered similar sentiments. "Unfortunately, Senator Bean's anemic proposal is like giving an aspirin tablet to a patient who needs open heart surgery," he said.
The bill rejects federal funds and offers just $10 a month in state funds to put in a "health-benefits account." To get it, the patient would have to put in $20 of his own (as the bill was originally written; however, Bean said that might be altered to $10).
So the result would be $20 to $30 a month that could be used to shop on a state-sponsored health-product exchange -- if anything were available at that price.
"Not only is it not coverage, it isn’t even a minimally adequate health savings account," said Florida CHAIN's Mellowe. If anyone signed up, they would still have to cover nearly 100 percent of their own medical expenses, he said.
Bean, R-Fernandina Beach, said he came up with the idea after committees in both the House and Senate rejected the idea of expanding Medicaid as called for by the Affordable Care Act, even though the expansion would bring $51 billion in federal funds over 10 years to cover those with incomes under 138 of the federal poverty level. About 1 million of Florida's 4 million uninsured would gain coverage under the plan, economists estimate.
State Sen. Joe Negron created an alternative that could qualify for the funds but avoid using traditional Medicaid. That plan, Healthy Florida, passed the Senate Appropriations Committee and won the governor's support.
But House Republican leaders said they didn't want to accept the federal funds. That's when Bean decided to come up with something that wouldn't rely on federal money.
His plan would be open to those at 100 percent of the poverty level -- but not all of them. He has suggested about $15 million in state funds to start it off, which is not enough to cover all of those in his targeted income range -- not even at $10 a month.
Bean estimated that about 740,000 adults in Florida are uninsured and under the poverty level. For an individual, that income limit is $11,490 this year, and for a three-person family, it's $19,530.
In previous sessions, the committee heard from State Chief Economist Amy Baker that the cost of covering an adult under Medicaid expansion was estimated at $340 a month.
Bean's plan would use the Florida Health Choices marketplace as the venue for the newly covered population to shop for health products. Its CEO Rose Naff told Health News Florida that there are products available for under $20 or $30 a month -- even one for $9.95 -- but they are not insurance in the usually accepted sense.
The product that costs about $10 would be a discount card for doctor and hospital expenses, she said. For $29.95, the card would also provide discounts for lab work, imaging, prescriptions and certain other health services.
Naff released a price sheet of plans that she expects the Health Choices online market will offer when testing is done, which she said will be soon. Here is the list:
In addition to the comprehensive medical coverage and dental plans that are currently being loaded into the online offerings, she said, the following companies have expressed interest in joining the marketplace and offer something less than major medical with hospital coverage:
2 Prepaid Health Clinics
Plan X Primary and Specialist Care, RX, lab, outpatient services, vision, chiropractic – basically, everything but inpatient hospital care. Comes with copays of $15 -$30 depending on the service. As low as $69 per month
3 Discount Medical Plans licensed in Florida are interested:
- Discount Plan - Labs, imaging, medical mediation, prescriptions, hearing, alternative health and fitness, diabetes supplies, nurse line and telemedicine products and services. $14.95-24.95 per month.
- Premier Plan – all of the above plus a physician network. $18.95-29.95 per month
- Plan A - Physician and hospital discount benefits, $9.95 per month
- Plan B - Physician, hospital, chiropractic, vision and pharmacy discount benefits. $14.95 per month
All the following can be purchased for less than $30 per month:
- Plan A – Physician and hospital services discount plan
- Plan B – Tele-health, medical bills saver, health advocate, physician and hospital
- Plan C – Discount Vision
- Plan D – Discount Dental
- Plan E – Discount Chiropractic
- Plan F - Diabetic Supplies
- Plan G – Telemedicine Services
- Plan H – Physician benefit
Life Style Benefits
- Discount Legal Services
- Identity Protection
Health Savings Account Administrator
Tele-Health Service Provider