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New state health exchange could become precursor to implement federal health care law

TALLAHASSEE — A fledgling state health insurance program could have an unintended consequence for Republicans who created it: helping President Barack Obama implement his controversial health care law in Florida.

Florida Health Choices is scheduled to open in early 2012, nearly four years after lawmakers first approved the plan and two years after Congress passed their own law.

U.S. Sen. Marco Rubio helped create the program when he was state House speaker. An expansion approved this year by lawmakers was applauded by Gov. Rick Scott. Both Florida Republicans want to repeal "Obamacare."

But before the state program can get on its feet, it might be consumed by the federal health care law.

At the center of the federal law are state insurance exchanges, web-based programs where businesses and individuals can search, compare and buy health coverage.

At its most basic, that is Florida Health Choices.

The program was designed to attract small businesses not providing health benefits and to cover some of the 3.8 million Floridians who remain uninsured. Companies and their employees can take advantage of federal incentives and contribute pre-tax dollars to pay premiums.

There are significant differences.

Unlike the federal law, Florida's program is not open to individuals, does not offer any new tax breaks for businesses and does not require insurers to offer minimum health benefits.

But if the federal law is upheld in court, some say Florida Health Choices could become the basis of an insurance exchange envisioned in the federal law.

"It has the potential," said former Sen. Durell Peaden Jr., a Panhandle Republican who serves on the Florida Health Choices board.

Peaden, a retired physician, said the work put into preparing Florida Health Choices would help the state implement the federal law.

"Everyone is pooh-poohing Obamacare and I don't like it, either," Peaden said. "But if something is coming down the pike, we will be ahead of it."

Others bristle at any comparison between the state and federal programs.

"We are not related to Obamacare at all," Florida Health Choices chairman Aaron Bean said. Bean, a Fernandina Beach Republican, was the House sponsor of the bill that created the program.

But Bean acknowledged the two programs could be merged when the federal law takes effect in 2014.

"It's scary that Obamacare, if it's enacted, that we could in fact be in jeopardy of our vision not being realized," he said. "We'd either have to play ball under the federal guidelines or shut down."

Lawmakers gave the program $1.5 million in state seed money. About $900,000 remains unspent, Bean said.

So far this year, Scott and the Legislature have returned or refused to spend at least $19 million in federal money associated with implementing the health care law, including $1 million to prepare for the exchange.

Rep. Scott Randolph, an Orlando Democrat on the House Health & Human Services Quality Subcommittee, said the state should have explored whether the federal cash could have been used for the state program.

"We're spending state money to do this, yet rejecting the federal money," Randolph said. "That's bad policy and certainly putting politics over someone's health."

Nationwide, state efforts to set up exchanges under the federal law have been slow getting off the ground, according to a Kaiser Health News report. So far about a dozen states have passed legislation enabling an exchange and Rhode Island is establishing one through an executive order.

Florida's exchange is a public-private partnership that gives businesses with 50 or fewer employees an online tool to shop and compare medical coverage. If the program is successful, it could be expanded to include vision and dental plans.

At least four employees would have to buy coverage for a company to participate.

After Massachusetts and Utah, Florida would be the third state with an insurance exchange.

Participation in the Florida program is voluntary for insurers, which would pay the exchange 2 percent of the premium of every policy sold. Agents would also pay $300 a year to participate.

Bean said he hoped to have about a half-dozen insurers participating. His goal is to cover 60,000 Floridians, but said even a fraction of that would be a success.

"I'm still focused on launching," Bean said. "And that can't come fast enough."

Michael C. Bender can be reached at or (850) 224-7263. Follow him on Twitter @MichaelCBender.

New state health exchange could become precursor to implement federal health care law 10/13/11 [Last modified: Thursday, October 13, 2011 10:18pm]
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