April 4, 2013

Senator Bean Proposes Health Choice Plus Program

Senator Bean offered Senate Bill 1844 as an alternative to Senator Negron's proposal to extend health care coverage to the uninsured. The bill was approved by the Senate Health Policy Committee, but has not been referred to other committees for hearings. The bill does not allow for the use of federal funding authorized under the Patient Protection and Affordable Care Act (PPACA); it establishes the "Health Choice Plus Program" and contains language that defines the program as follows:

Background

  • Establishes a "benefit program" for uninsured individuals under 100 percent of the federal poverty level
  • Expands the Florida Health Choices Program to manage the new approach to health care service delivery
  • Creates "Health Benefits Accounts" to allow enrollees to gain access to primary care, preventive care, insurance products and health care related items

Eligibility

  • Individuals age 19-64, not Medicaid eligible, without employer sponsored insurance or eligible for PPACA coverage
  • Must be legal Florida resident
  • Must enroll dependent children in the Children's Health Insurance Program (CHIP) or Medicaid, if eligible
  • Complete a health assessment, a preventive visit and achieve optional healthy living goals
  • Provide proof of employment or equivalent requirements

Enrollment

  • Occurs through Florida Health Choices, Children and Families, Florida Healthy Kids Corporation, or the federal exchange
  • Open enrollment at least once a year
  • Capped when available funding limit is reached
  • Electronic eligibility is preferred

Health Benefits Accounts

  • Administered by Florida Health Choices which establishes standards and guidelines
  • Resources can be used for insurance products and services offered by the Florida Health Choices marketplace or to offset other health care costs
  • Health care costs include physicians, hospitals, prescriptions, insurance premiums, copayments, coinsurance and other health care costs

Funding

  • No federal funds are authorized to be used for this program
  • Enrollee's must contribute at least $20 per month with option for employers to pay the enrollee share
  • State funds allocated to the individual accounts cannot exceed $10 per month
  • Employer based contributions are allowed with no limit