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State government tries to puzzle through new health care law

TALLAHASSEE — Florida businesses small, medium and big alike are trying to make sense of the new health care law and what it means for their bottom line.

It's no different for Florida's biggest employer, the state of Florida.

Though Gov. Rick Scott fought the law since its infancy and Attorney General Pam Bondi took the matter all the way to the U.S. Supreme Court, Florida lawmakers are now awkwardly having to comply with key provisions of the health care law — including offering health insurance to thousands of additional state workers.

"The budget we proposed includes the mandatory portions of the president's new health care law, which means the state needed to provide coverage for state employees or pay a per-employee penalty to the federal government," said Melissa Sellers, the governor's spokeswoman.

How the state implements the federal health care law for its 160,000 employees is a separate question from whether lawmakers decide to expand the state's Medicaid program to cover additional Floridians.

Some work already has occurred, and some is getting started.

State workers can now include children younger than 26 on their health insurance plans, the state's insurer is barred from refusing to sign up minors because of pre-existing conditions, and annual dollar-amount caps were eliminated.

The changes cost the state $16 million in the current budget year, officials say.

Even bigger changes come in 2014. First, new taxes and fees are expected to increase Florida's insurance costs by $20.4 million.

In addition, thousands of temporary state workers may now be eligible for insurance. That could cost an additional $29 million next year.

All together the state says it will spend about $60 million implementing the Affordable Care Act for its employees, though some of those costs could be offset by the premiums that employees pay.

As part of the health care law, companies with 50 or more employees must offer all full-time workers health insurance. If they don't, and the federal government subsidizes even one employee's health care costs, it triggers huge fines. (Florida could face a fine of up to $318 million.)

The law goes further, broadening the definition of a full-time employee to include anyone who works more than 30 hours a week.

For the state, that means about 10,000 people who are filling temporary, contract positions in all branches of government could now be eligible for insurance.

The state is still trying to determine how many of its employees would be eligible and how many would sign up for the state's insurance plan. Right now, the assumption is that roughly two-thirds (6,300) would enroll.

Many state agencies hire contract workers for seasonal positions or special projects such as lifeguards at state parks during the summer or extra customer service representatives to assist with a backlog of unemployment compensation applications.

"My understanding is that it's driven by the number of hours worked," said Sharon Larson, the Department of Management Services' director of human resources management. But the federal government hasn't said exactly how hours will be calculated, Larson said.

For example, is someone who works 30 hours in one week but averages less than that in a month or year still eligible to join the state health plan?

The issue becomes even muddier at the state's 12 public universities, where the bulk of Florida's contract employees work. They include adjunct professors and graduate assistants, as well as a myriad of clerical and administrative workers.

Many of them don't work during summers or during the long winter holiday break.

"One of the issues we're running into is the definitions piece of this," said Tim Jones, chief financial officer for the Board of Governors.

So far, each university has provided its own estimates about the number of full-time contract employees. The numbers range from 2,948 at the University of Florida to just 381 at the University of Central Florida, which has the state's largest student population.

Later this month, human resources directors from all of the universities will meet with the state's Department of Management Services to discuss the impacts of the Affordable Care Act and revise their criteria for identifying eligible employees.

Contact Tia Mitchell at or (850) 224-7263.

Impact of Affordable Care Act on the state employee health plan for fiscal 2013-2014

Offering insurance to full-time contract employees: $28.7 million

Additional fees and taxes that increase cost: $20.4 million

Eligible employees that currently opt-out deciding to enroll: $8.3 million

Eliminating pre-existing coverage limitations: $2 million

Patient-centered outcome fee ($2 per employee): $750,000

Total: $60 million

Sources: Impact on the State Health Insurance Program of the Patient Protection and Affordable Care Act, Dec. 12, 2012, Florida Self-Insurance Estimating Conference

State government tries to puzzle through new health care law 02/10/13 [Last modified: Sunday, February 10, 2013 8:53pm]
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