State would look to Washington on health insurance rates

State would look to Washington on health insurance rates

By Jim Saunders

The News Service of Florida

     THE CAPITAL, TALLAHASSEE, FL — Expecting the federal Affordable Care Act to drive up health-insurance costs, a Florida Senate select committee Monday (Mar. 18, 2013) backed a proposal that would rely on Washington to review and approve rates in the state.

    The proposal would temporarily suspend rate-setting powers of the state Office of Insurance Regulation, which would keep the authority to review various other types of regulatory information submitted by health insurers.

    Senate Banking and Insurance Chairman David Simmons, a Maitland Republican who also serves on the select committee, said lawmakers are taking a “common sense” approach as the Affordable Care Act gets ready to fully take effect in 2014. He and other lawmakers say the state doesn’t know all of the ramifications of the federal health law, which includes requirements that are different than state insurance regulations.

    “We want to make sure we are in compliance, that we’re doing what we’re required to do,’’ Simmons said.

    Sen. Audrey Gibson, a Jacksonville Democrat who also serves on the select committee, said it appeared lawmakers wanted to make sure they are not blamed for potential rate increases.

    But select committee Chairman Joe Negron, R-Stuart, said it’s not all about blame. He pointed to changes in the federal law, such as a requirement that health plans issue policies to people regardless of health status — a concept known in the insurance industry as “guaranteed issue.”

    “I think it’s going to be difficult for OIR to assess what a reasonable rate is,” Negron said.

    He also said the Office of Insurance Regulation’s continued oversight of other insurer filings would be designed to ensure consumer protections.

    “I don’t think we should walk back from those,’’ Negron said.

    The select committee, which has been studying the Affordable Care Act for weeks and held its final meeting Monday, made recommendations that will be further developed in other committees. A House select committee has been working on the same issues.

    Also Monday, the Senate committee recommended offering health-insurance coverage to thousands of temporary state employees who work an average of 30 hours of week or more. Those employees are currently barred from the state-employee health insurance program, but the Affordable Care Act would impose major financial penalties on Florida if they are not offered coverage.

The committee last week dealt with the most-controversial issue involved in carrying out the Affordable Care Act — whether to expand Medicaid to include hundreds of thousands of people who are not currently eligible. The Affordable Care Act, better known as Obama-care, calls for expanding Medicaid eligibility up to 138 percent of the federal poverty level and, in one of the biggest changes for Florida, allowing childless adults to enroll.

    Committee members voted against an expansion, but Negron offered an alternative plan that would use a long-running program, the Florida Health Kids Corp., as a vehicle to offer private insurance to people up to 138 percent of the poverty level. To help pay for the coverage, Negron’s proposal would rely on federal money that otherwise would go toward Medicaid expansion.

    But Senate Health Policy Chairman Aaron Bean, R-Fernandina Beach, said his committee will hold a workshop Wednesday on another concept.

    Under that concept, people whose incomes are between 100 and 138 percent of the federal poverty level could get coverage through health-insurance exchanges, another part of the Affordable Care Act. The exchanges will serve as online insurance marketplaces, with the federal government offering subsidies to people whose incomes are between 100 percent and 400 percent of the federal poverty level.

    For people below 100 percent of the federal poverty level, Bean wants to explore making coverage available through the Florida Health Choices program, which lawmakers approved in 2008 as a type of insurance marketplace but has not started operating. Bean is a former chairman of the Florida Health Choices board and helped get the program approved while serving in the House.