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Showdown looms in Legislature over health care plans

TALLAHASSEE — They gathered in the speaker's office Monday to pray and to read aloud the stories of poor, uninsured Floridians.

They wanted someone to listen, they wanted House Speaker Will Weatherford to listen, to hear who would benefit if Weatherford and others simply said yes to $51 billion in federal health care help.

They promised to do it again — the 10-or-so of them — today, tomorrow and next week if need be. "This is the 100 percent speaking, not just the tea party," said Wilson Barnes, a 72-year-old veteran and Tallahassee resident. "And I want our speaker . . . to listen to our word, to listen to the word of God, and let's look out for all 100 percent of Floridians."

They may not get the decision they want.

A Republican-controlled House committee on Monday agreed to forgo federal health care aid and instead create a state-subsidized plan that House leaders say is more sustainable but also provides health care to far less people.

The decision sets up a showdown between the Republicans in the House and Senate and Gov. Rick Scott, who each have different ideas on how to provide health care coverage to poor Floridians. With less than three weeks until the end of the legislative session, it's unclear what, if anything, will get done.

Republicans in the House on Monday praised their plan, which would provide state subsidized health insurance to about 130,000 people, as a commonsense approach that will make participants healthier and puts the state on solid financial grounds.

"Clearly this debate we're having today is occurring in many state houses around the country," said Rep. Matt Hudson, R-Naples. "What we're doing is not necessarily unique to the debate that we're having, but the solution that we offer is more than unique, it's visionary."

The Senate has other options on the table and, depending on how members vote later this week, they could either fall in line with House Republicans or take a different approach.

One option created by Sen. Joe Negron, R-Stuart, would rely on the billions of dollars in federal assistance and allow 1 million or more Floridians purchase health care on the private insurance market. Another plan, by Fernandina Beach Republican Sen. Aaron Bean, is similar to the House Republicans' proposal.

Neither chamber is considering expanding Medicaid as originally contemplated by the federal health care law.

Negron's plan has bipartisan support, the backing of Scott and is embraced by hospitals and patient advocates. The question is whether the Senate is willing stand by its plan even if it means a fight with the House.

Negron said he's willing to talk with House leaders.

"There's kind of two plans that have emerged, and I want to explore if there is a way to have a hybrid of the two or some ability to have movement on both sides so we can reach compromise," Negron said. "And I just don't know. I can't predict the future."

If neither side budges, there is a chance that nothing gets done before session ends May 3.

House Democrats are hoping that the threat of a Scott veto may entice House Republicans to bend.

The governor criticized the House plan last week and reiterated his support for the Negron plan. So far, however, Scott has made business tax breaks and raises for teachers and state workers his session priorities.

He has not said if he would veto a health plan that does not accept federal dollars.

"The governor carries a big stick in negotiations," House Minority Leader Perry Thurston, D-Plantation, said. "He can decide how far he wants to push this, and we'll get to see how serious he is about giving affordable health care. If he's willing to hold their feet to the fire, we'll get something done."

The group of activists who met with Weatherford are planning to keep a constant presence in his office. Every hour this week, they will read the story of a different Floridian that would benefit from Medicaid expansion.

The group says it represents health care workers, clergy and veterans. A separate group led by the Florida Hospital Association is also holding rallies and lobbying on behalf of Medicaid expansion or Negron's plan in the Senate.

Tony Carvalho, president of the Safety Net Hospital Alliance of Florida, said much of their strategy will depend on which proposals seem to be garnering support this week. He also is prepared for the conversation to continue after the final day of session.

"We certainly would like a plan adopted prior to the end of session, but the debate and discussion and opportunities don't end then," Carvalho said. "There's no federal dollars that are going to flow until Jan. 1 of 2014."

Differing health care plans

Who would be eligible?Who pays?
OptionProposed byWhat is it?How many people would be covered?Adults between 100% and 138% of the federal poverty level (single person $11,490-$15,856)Parents under 100% of the federal poverty level (less than $15,510 for family of 2)Disabled Floridians under 100% of the federal poverty level (single person under $11,490)Childless adults under 100% of the federal poverty level (single person under $11,490)Premiums and co-pays10-year cost to state10-year cost to federal government
Senate plan (SB 1816)Sen. Joe Negron, R-StuartCreates a new state-based health insurance program for the uninsured.Anyone who is eligible would be able to enroll. The eligible population is the same as for Medicaid expansion, meaning enrollment could reach 910,324 by 2023.YesYesYesYesPremiums $15-$20 a month; co-pays $10 or less.$3.5 billion$51 billion
Senate plan (SB 1844)Sen. Aaron Bean, R-Fernandina BeachCreates a state program to help the uninsured pay for basic coverages by subsidizing the costs.Roughly 550,000 are eligible, but funding would limit the number that are able to enroll. Bean wants enough money to cover about half.No*YesYesYesPremiums at least $20 a month; state would contribute up to $120 annually.$300-$400 million (estimated)0
House plan (no bill number)Rep. Richard Corcoran, R-Land O' LakesCreates a state program to help the uninsured pay for basic coverages by subsidizing the costs.Anyone who is eligible would be able to enroll. The House estimates the program will grow to 130,000 people by 2023.No*YesYesNoPremiums $25 a month. State provides $2,000 annually.$2 billion0
Medicaid expansion (no bill number)President Barack ObamaExpands the existing Medicaid insurance coverage to more Floridians.Anyone who is eligible would be able to enroll. State analysts estimate that 910,324 people would enroll by 2023.YesYesYesYesUsually no premium; co-pays $1-$3 for most visits.$3.5 billion$51 billion

*Adults making over 100% of federal poverty would be eligible to purchase insurance on health exchanges using federal subsidies.

Showdown looms in Legislature over health care plans 04/15/13 [Last modified: Monday, April 15, 2013 10:59pm]
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