Crist unveils plan for pared-down, cheaper policies
By Christine Jordan Sexton
2/20/2008 © Florida Health News
TALLAHASSEE -- Saying he has a “sympathetic heart,’ Gov. Charlie Crist unveiled a health care agenda Tuesday that aims to find all of Florida’s uninsured residents and offer them the opportunity to buy a health insurance policy for $150 or less a month. Crist’s plan would allow insurance companies to sell policies with pared-back benefits but require them to sell to all comers – including those who are at higher risk for illness.
The governor's office has said three or four companies have shown interest in bidding on the plan, but Humana, one of the major players in the Florida market, isn't one of them, said Harry Spring, regional director of government relations. The requirement that the companies sell to everyone would doom the plan financially, he said.
The state would negotiate with the insurers to determine which ones could participate. The governor’s plan faces competition from a legislative leader of his own party, Rep. Aaron Bean, R-Fernandina. Bean, chairman of the House Health Care Policy Council, said Tuesday he also wanted to see pared-down plans but wants to work through employers and use tax-deductible health savings accounts.
Bean said he will unveil details in two to three weeks. As for differences with the governor’s approach, he said, “We can work it out. Crist’s first year in office was spent tackling soaring property taxes and homeowners’ insurance, but the governor said his attention has switched to health care because he “has a sympathetic heart.” He said that health care is one of his top three priorities for the upcoming legislative session, which starts on March 4.
Crist told Florida Health News that he wants to do all he can to set uninsured Floridians' minds at ease. “Paying for health coverage can create significant worries and I like to try to alleviate it if we can," he said.
The percent of uninsured citizens in Florida has been rising and in 2007, the Census Bureau estimated that there were 3.6 million people in Florida without health insurance. Under Crist’s proposal, participating companies would have to offer two plans. Both plans would cover preventive care, such as check-ups and mammograms, and primary care – visits to the doctor. One plan would also cover hospital care and emergency services. The Office of Insurance Regulation and the Agency for Health Care Administration are to work together to define the requirements for participation in what Crist calls his “Cover Florida Plan.”
The state would contract with at least one company that has a statewide network and could enter contracts with a number of smaller regional networks. Health plans and others bidding on the uninsured would have flexibility to set coverage limits; for example, one company’s proposal may include fewer days of hospitalization than another’s but make it up with more doctor visits per year.
Companies could also set different co-payments. deductibles and caps on total spending. What we are putting forth costs the state nothing,” Crist said. “It’s about negotiating well.”
Companies are not required to participate and – unlike the Massachusetts health law – Floridians do not have to buy the insurance, even if they can well afford to. Insurers will be interested in bidding because of the flexibility and the potential to attract new customers, predicts Mary Beth Senkewicz, Florida’s deputy insurance commissioner for life and health. The risk is minimal because they can set limits on coverage.
“I don’t see any particular red flag” for insurers, she said. “There is (also) some degree of being a good corporate citizen that goes into the thinking of insurance companies and I am sure they will take that into evaluation as well.”
But Humana's Spring said there are affordable health insurance options in the market today with similar price points. As an alternative to requiring insurers to bid on the uninsured the state should develop a website that lists each insurance company's and HMO's top-selling plans, he said. Such a website would show consumers that "there are better products with similar prices from all of us (insurance companies) now," he said.
Spring is critical of another part of Crist's health agency -- the idea of allowing adult children to remain on their parents' health policy until they reach the age of 30. While that would address a large part of the uninsured adult market, it would raise the cost of the parents' insurance, he said.
Sticking with a campaign promise to cut back on regulatory red tape, Crist’s health care proposal also would eliminate a state law that requires a “certificate of need,” or CON, for new hospital construction. Instead, Crist would require hospitals to provide certain levels of Medicaid and charity care.
Hospitals that fail to meet the requirements could be fined twice the amount that the care would have cost. ist’s CON proposal would also make it more difficult for a hospital’s competitors to interfere with a change of ownership.
“I’ve never been a huge fan of that kind of government involvement,” Crist said. ““I view (CON) as ‘I’m in the club and I’m going to close the door behind me and nobody else is allowed to participate or compete.’”
Crist also wants to eliminate a restriction on KidCare that bars families with incomes above the program limits from paying full cost to buy coverage for their children.
He also wants to allow dental hygienists to work at county health departments without direct supervision of a dentist.
