It was the brainchild of then-Speaker Marco Rubio: a health insurance exchange to help Floridians and small businesses find affordable health coverage.
The Florida Health Choices insurance exchange never quite lived up to Rubio’s vision as it competed with a rival marketplace created under the Affordable Care Act. Now, the state-based exchange could fold after Gov. Rick Scott vetoed funding intended to keep it afloat another year.
Without the $250,000 allocation, there is little money to pay Chief Executive Officer Rose Naff and keep the website maintained.
“We will have to close our doors and go to some sort of virtual office or contract it out to another entity,” Naff said.
The Florida Health Choices board of directors has to decide what to do with the 3-year-old exchange, which has about 712 existing customers, far fewer than the 3,000 to 4,000 needed for the exchange to be self-sufficient. It has received more than $2 million in state funding since its inception.
Floridians who purchased policies or coverage plans on the exchange won’t lose their coverage in the short term, but new sales could be halted.
The FHC Board of Directors will meet via teleconference June 23. Among the options the group will discuss is dissolving the corporation sometime after the start of 2018.
Rubio has said little about Florida Health Choices since becoming a member of the U.S. Senate. His idea was part of a 2006 book, but the Affordable Care Act stole much of its thunder when it was signed into law in 2010. Florida’s exchange had not yet launched because of vendor issues and other delays.
The GOP-controlled Legislature could have approved changes at Florida Health Choices so that it fit within the requirements of the new federal law, but members resisted because they disagreed politically with former President Barack Obama. Florida Health Choices began selling policies in 2014 but had relatively few takers. Unlike the Obamacare exchange, Florida’s marketplace could not offer subsidies to help customers afford coverage.
To attract more customers, Florida Health Choices began offering discount plans as an alternative to comprehensive coverage. The Legislature provided more dollars to keep it afloat, largely in the hopes the Affordable Care Act would be struck down by courts or dismantled by a Republican-led Congress.
“I don’t know if it’s an idea that was before its time or maybe just too late for its time,” said Sen. Anitere Flores, a Miami Republican and chairwoman of the Florida Senate’s health care budget committee.
In vetoing the $250,000 contained in the 2017-2018 state budget, Scott said he did not approve of spending public dollars on marketing the exchange at the expense of direct client services. He also described Florida Health Choices as a private venture, even though the Legislature has always said it is a public-private initiative.
Naff said the governor’s office did not request any information ahead of the veto or let her know the funding was in jeopardy.
“The veto message sounds like they don’t actually understand the program or the value they have for small employers,” she said.
Since Rubio’s exit, the biggest voice in the Legislature for Florida Health Choices has been Sen. Aaron Bean, R-Fernandina Beach. He is the one who submitted paperwork requesting the $250,000 and fought for funding to be included during budget negotiations with House members during the regular session that ended in May.
He said the money was the first step to reaching three goals: keeping the state exchange alive, increasing the number of customers and serving as a backup plan in case changes to Obamacare are made at the federal level.
“I feel so strongly about keeping them as a health care option,” Bean said. “It’s that important.”
The Senate likely won’t take another shot at restoring funding for Florida Health Choices until the 2018 session begins in January. That could be too late. Naff said there is only enough cash to keep the office open for another month or two.
“We’ll have to make some pretty big changes this summer,” she said.
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