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Insurance Choices Debated

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By CATHERINE DOLINSKI

The Tampa Tribune

Published: April 9, 2008

TALLAHASSEE - A House bill carrying Gov. Charlie Crist's proposal to offer limited-benefit health insurance could confuse or even coerce Floridians into buying insurance that does not meet their needs, state insurance regulators warned Tuesday.

Crist has made a high priority of his plan to extend low-cost insurance with limited benefits to the low-income uninsured. The plan, which would force insurers to accept all applicants and require that any plan include certain benefits such as preventive health screenings, easily passed the Senate Health and Human Services Appropriations Committee last week and is headed for a full chamber vote.

But the plan has faced competing proposals in the House, and ultimately arrived at the House Healthcare Council on Tuesday wrapped into a bill that also contains a competing insurance plan that would go virtually unregulated by the state.

Dubbed by House leaders as the "farmers' marketplace," the competing program also would create low-cost insurance products but not require them to offer any specific benefits. The Agency for Health Care Administration and Office of Insurance Regulation, which would oversee the program proposed by Crist, would lack authority to regulate the House's program.

"Nobody's told what to sell; nobody's told what to buy," House Healthcare Council Chairman Aaron Bean, R-Fernandina Beach, said in an interview after his panel passed the legislation along party lines Tuesday. "Both of them offer more choice to individuals trying to get coverage."

Mary Beth Senkewicz, deputy commissioner for Life and Health at the state Office for Insurance Regulation, called the bill "consumer unfriendly" and warned that the programs would create confusion. Senkewicz's office supports Crist's part of the bill.

During Tuesday's Healthcare Council meeting, Rep. Joyce Cusack raised similar concerns about the ability of consumers to discern the differences between plans. "You don't want to wait until you need the product and find out what you thought was there is not there, and there's no recourse."

Employers Could Switch Coverage

In an interview, Bean argued that the two proposals can coexist.

"What's better: chicken or steak?" he asked. "Could they both be compatible in the same restaurant? Why would we limit people's choices if we're truly out to tackle the uninsured? We know that one size does not fit all."

Senkewicz said the House bill appears to permit qualifying employers to drop the coverage they currently provide to their employees in favor of the limited-benefits alternative proposed by the House.

Employers would be able to enroll employees into the cheaper plan, Senkewicz said; employees would have to take action to "opt out" if they did not want it. "There is nothing in that section, provision, that talks about what kind of notice the employee has to get from the employer - in fact there wasn't even a requirement that the employer give the employee notice of this, that they would have to opt out of what the employer has decided ... next thing they know, they're minus $600 out of their paycheck, because they didn't opt out."

A Work In Progress

Bean said he has no problem with employers switching to the cheaper insurance program. But it is not, he said, his intent to "force this down anybody's throat."

He is particularly concerned, he said, about language that Senkewicz and some Democrats think could allow employers to make enrolling in the program a condition of employment.

The House bill also omits the governor's proposal to lift the cap on enrollment in KidCare, the state's health insurance program for low-income children, for those with incomes greater than 200 percent and who pay full premiums for the coverage. Bean said that provision would have increased costs.

Crist's office did not respond to requests for comment on the bill. Bean stressed that the legislation, which heads next to the House Policy and Budget Council, remains a work in progress.

Reporter Catherine Dolinski can be reached at (850) 222-8382 or cdolinski@tampatrib.com.

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